Research Reports - Systematic review of traumatic brain injury and the impact of antioxidant therapy on clinical outcomes

Worldviews Evid Based Nurs. 2016 May 31. doi: 10.1111/wvn.12167. [Epub ahead of

Shen Q(1), Hiebert JB(2), Hartwell J(3), Thimmesch AR(4), Pierce JD(5).

BACKGROUND: Traumatic brain injury (TBI) is an acquired brain injury that occurs
when there is sudden trauma that leads to brain damage. This acute complex event
can happen when the head is violently or suddenly struck or an object pierces the
skull or brain. The current principal treatment of TBI includes various
pharmaceutical agents, hyperbaric oxygen, and hypothermia. There is evidence that
secondary injury from a TBI is specifically related to oxidative stress. However,
the clinical management of TBI often does not include antioxidants to reduce
oxidative stress and prevent secondary injury.
AIMS: The purpose of this article is to examine current literature regarding the
use of antioxidant therapies in treating TBI. This review evaluates the evidence
of antioxidant therapy as an adjunctive treatment used to reduce the underlying
mechanisms involved in secondary TBI injury.
METHODS: A systematic review of the literature published between January 2005 and
September 2015 was conducted. Five databases were searched including CINAHL,
PubMed, the Cochrane Library, PsycINFO, and Web of Science.
FINDINGS: Critical evaluation of the six studies that met inclusion criteria
suggests that antioxidant therapies such as amino acids, vitamins C and E,
progesterone, N-acetylcysteine, and enzogenol may be safe and effective
adjunctive therapies in adult patients with TBI. Although certain limitations
were found, the overall trend of using antioxidant therapies to improve the
clinical outcomes of TBI was positive.
LINKING EVIDENCE TO ACTION: By incorporating antioxidant therapies into practice,
clinicians can help attenuate the oxidative posttraumatic brain damage and
optimize patients' recovery.

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