par Cruickshank, J M;Neil-Dwyer, G;Degaute, Jean-Paul ;Hayes, Y;Kuurne, T;Kytta, J;Vincent, Jean Louis ;Carruthers, M E;Patel, S.
Référence Lancet, 2, 8559, page (585-589)
Publication Publié, 1987-09
Référence Lancet, 2, 8559, page (585-589)
Publication Publié, 1987-09
Article révisé par les pairs
Résumé : | 114 haemodynamically stable patients with acute head injury were randomised, double-blind, to either placebo or atenolol given intravenously (10 mg every 6 h) for 3 days then orally (100 mg daily) for a further 4 days. Both groups were equally stressed as shown by raised arterial noradrenaline levels. In patients receiving placebo, but not in those receiving atenolol, there was a significant (p less than 0.01) positive correlation between arterial noradrenaline and levels of the myocardial isoenzyme of creatine kinase (CKMB). 30% of the placebo group compared with 7.4% of the atenolol group (p less than 0.05) showed CKMB levels greater than 3% of total creatine kinase (compatible with myocardial damage). CKMB levels greater than 6% of total creatine kinase (compatible with acute myocardial infarction) were present in 16.7% of patients receiving placebo but in no patients receiving atenolol (p = 0.053). Atenolol appeared to reduce significantly the likelihood of supraventricular tachycardia and ST-segment and T-wave changes and prevented cardiac necrosis seen at necropsy. |