Effect of amantadine in comatose patients: Traumatic brain injury versus post-cardiac resuscitation syndrome

Abstract

Background & Objective: Amantadine is considered to be effective in facilitating awakening from a coma both after traumatic brain injury (TBI) and following the return of spontaneous circulation (ROSC) after cardiac arrest. The aim of this study is to share our observations of TBI and ROSC patients in the intensive care unit (ICU) who were administered amantadine to enhance wakefulness.

Methods: This retrospective study involved patients treated in a tertiary ICU. The patients were divided into two groups: TBI group and ROSC group. Demographic data such as age, gender, reason for hospital admission, and comorbidities were recorded. The outcomes assessed included length of ICU stay, duration of hospital stay, mortality rates, and discharge rates.

Results: TBI group had a mortality rate of 23.4% and a survival rate of 76.6%, while the ROSC group had a mortality rate of 46.4% and a survival rate of 53.6%, with TBI group experiencing significantly better outcomes. Regarding patients’ GCS scores at the start and end of amantadine treatment, in TBI group, the average GCS was 5.7 on the first day and 9 on the last day of treatment (p <0.001). In ROSC group, the average GCS was 5 on the first day and 7.1 on the last day of treatment (p <0.001). These changes were found to be statistically significant.

Conclusion: This study demonstrated that amantadine treatment effectively improved GCS scores in both TBI and ROSC patients. However, this study also showed that TBI patients experienced better outcomes than ROSC patients.