ReviewJournal of anesthesia, analgesia and critical care2025
Beta-blockers in adults with acute traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials.
Review in Journal of anesthesia, analgesia and critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- State-of-the-art review: ß-blockade in critical illness.Intensive care medicine · 2026Review
- Neuro-immune dysregulation after traumatic brain injury: immunomodulatory strategies to prevent infectious complications.Frontiers in molecular neuroscience · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTraumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Beyond the primary insult, excessive sympathetic activation contributes to secondary brain injury and poor outcomes. Beta-blockers may attenuate this hyperadrenergic surge and provide neuroprotective benefits, but their efficacy in improving long-term functional recovery remains uncertain.
methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating beta-blockers in adults with acute TBI. We searched MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov for RCTs comparing beta-blockers with placebo, usual care, or non-adrenergic comparators. Our primary outcome was long-term functional outcome, assessed with the Glasgow Outcome Scale (GOS) or its Extended version (GOS-E). Secondary outcomes included mortality, intensive care unit (ICU) and hospital length of stay, duration of mechanical ventilation, and adverse events.
resultsSeven RCTs (n = 559) met inclusion; six (n = 445) contributed data to meta-analyses. Only two trials (n = 259) reported functional outcomes. Beta-blockers did not significantly reduce the risk of unfavorable neurological outcome (RR 0.81; 95% CI 0.57-1.15; very low certainty). In contrast, beta-blocker therapy was associated with a reduction in mortality (RR 0.57; 95% CI 0.39-0.82; 6 trials, n = 440; low certainty) and a shorter duration of mechanical ventilation (-1.58 days; 95% CI -2.91 to -0.26; 2 trials, n = 85; low certainty). No effect was observed on ICU or hospital stay. Adverse event reporting was sparse, but no consistent safety concerns were identified.
conclusionsIn adults with acute TBI, beta-blockers did not decrease unfavorable long-term neurological outcomes but were associated with lower mortality and shorter duration of mechanical ventilation. Given the small number of trials and very low certainty of evidence, definitive conclusions cannot be drawn, and routine use cannot be recommended. A large, well-designed RCT is needed to establish the efficacy and safety of beta-blockers in this population. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024565361.
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