Medical Science
| Open Access |
DOI: NSAID-Augmented Therapy for Cerebral Edema in Severe Traumatic Brain Injury: A Clinical Study
Visolat Khamzaevna Sharipova , Doctor of Medical Sciences, Professor. Scientific Director of the Department of Anesthesiology and Resuscitation at the Republican Scientific Center for Emergency Medical Care. Tashkent, Uzbekistan Temur Khayrullaevich Ashurov , Postgraduate student in the basic doctoral program at the Bukhara State Medical Institute. Bukhara, UzbekistanAbstract
Background: Severe traumatic brain injury (sTBI) is characterized by intense neuroinflammation and progressive cerebral edema, which significantly impact morbidity and mortality. Conventional anti-edema therapies often provide limited control over the inflammatory cascade. This study evaluates the clinical efficacy of augmenting standard treatment with Nimesulide, a non-steroidal anti-inflammatory drug (NSAID), to mitigate cerebral edema and improve neurological recovery.
Methods: A prospective clinical study was conducted on 150 patients with sTBI. Patients were divided into two groups: the Main Group (n=115), receiving standard intensive care supplemented with Nimesulide, and the Control Group (n=35), receiving standard therapy alone. Neurological status was assessed using the Glasgow Coma Scale (GCS) on days 1, 5, and 10. Secondary outcomes included the incidence of complications (pneumonia, seizures), laboratory markers of systemic inflammation (Neutrophil-to-Lymphocyte Ratio - NLR), and neuroimaging dynamics via MSCT and ophthalmoscopy.
Results: On day 1, GCS scores were comparable between groups (9.1±1.2; p>0.05). By day 10, the Main Group showed significantly higher neurological recovery (13.1±1.7) compared to the Control Group (11.5±1.6; p<0.05). NSAID-augmented therapy was associated with a lower incidence of pneumonia (19.1% vs 28.6%) and post-traumatic seizures (14.8% vs 25.7%; p<0.05). Laboratory findings revealed a more rapid normalization of NLR and endotoxicosis markers in the Main Group. MSCT and ophthalmoscopy confirmed accelerated regression of cerebral edema and earlier stabilization of the artery-to-vein ratio (1:1.5) in patients receiving supplemental anti-inflammatory therapy.
Conclusion: Augmenting standard sTBI protocols with Nimesulide significantly accelerates neurological recovery, reduces the volume of cerebral edema, and lowers the frequency of life-threatening complications. These findings suggest that targeting neuroinflammation is a crucial component in optimizing outcomes for patients with severe traumatic brain injury.
Keywords
Severe traumatic brain injury, Cerebral edema, Neuroinflammation
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