Pharmacological and non-pharmacological interventions for altered consciousness and agitation following paediatric acquired brain injury: a scoping literature review.

Abstract

This scoping literature review aimed to investigate the breadth of pharmacological and non-pharmacological interventions targeting agitation and altered consciousness following paediatric ABI and evaluate the quality of evidence for these interventions. Using scoping review methodology, four databases were systematically searched to identify sources of evidence describing the use of pharmacological and non-pharmacological interventions targeting children's levels of consciousness and/or agitation during inpatient hospital care following ABI. Articles were screened by title and abstract and data from eligible studies were extracted for synthesis. Thirty-five studies were included and investigated the use of pharmacological (<i>n</i> = 12), non-pharmacological (<i>n</i> = 18), and alternative or complementary therapy approaches (<i>n</i> = 5). Approaches to assessing children's levels of consciousness and agitation were highly variable. The highest quality studies investigated the use of dopaminergic agents (amantadine and pramipexole), an atypical antipsychotic (ziprasidone), multidisciplinary rehabilitation approaches, and sensory stimulation. Overall, the included studies yielded mixed findings. This review highlights the paucity of high-quality experimental studies investigating the use of pharmacological and non-pharmacological approaches to managing altered consciousness and agitation for children following ABI. Further research is needed to determine their efficacy and inform recommendations to guide clinical practice.