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Correlation of Cerebral and Subcutaneous Glycerol in Severe Traumatic Brain Injury and Association with Tissue Damage
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.
Department of Anesthesia and Intensive Care, Section of Neurosurgery, Örebro University Hospital and Department for Medical Sciences, Faculty of Health and Medicine, Örebro University, Örebro, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.ORCID-id: 0000-0003-3528-8502
2022 (Engelska)Ingår i: Neurocritical Care, ISSN 1541-6933, E-ISSN 1556-0961, Vol. 36, s. 993-1001Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: This study is a substudy of a prospective consecutive double-blinded randomized study on the effect of prostacyclin in severe traumatic brain injury (sTBI). The aims of the present study were to investigate whether there was a correlation between brain and subcutaneous glycerol levels and whether the ratio of interstitial glycerol in the brain and subcutaneous tissue (glycerolbrain/sc) was associated with tissue damage in the brain, measured by using the Rotterdam score, S-100B, neuron-specific enolase (NSE), the Injury Severity Score (ISS), the Acute Physiology and Chronic Health Evaluation Score (APACHE II), and trauma type. A potential association with clinical outcome was explored.

Methods: Patients with sTBI aged 15–70 years presenting with a Glasgow Coma Scale Score ≤ 8 were included. Brain and subcutaneous adipose tissue glycerol levels were measured through microdialysis in 48 patients, of whom 42 had complete data for analysis. Brain tissue damage was also evaluated by using the Rotterdam classification of brain computed tomography scans and the biochemical biomarkers S-100B and NSE.

Results: In 60% of the patients, a positive relationship in glycerolbrain/sc was observed. Patients with a positive correlation of glycerolbrain/sc had slightly higher brain glycerol levels compared with the group with a negative correlation. There was no significant association between the computed tomography Rotterdam score and glycerolbrain/sc. S-100B and NSE were associated with the profile of glycerolbrain/sc. Our results cannot be explained by the general severity of the trauma as measured by using the Injury Severity Score or Acute Physiology and Chronic Health Evaluation Score.

Conclusions: We have shown that peripheral glycerol may flux into the brain. This effect is associated with worse brain tissue damage. This flux complicates the interpretation of brain interstitial glycerol levels. We remind the clinicians that a damaged blood–brain barrier, as seen in sTBI, may alter the concentrations of various substances, including glycerol in the brain. Awareness of this is important in the interpretation of the data bedside as well in research.

Ort, förlag, år, upplaga, sidor
Springer, 2022. Vol. 36, s. 993-1001
Nyckelord [en]
Brain computed tomography, Glycerol, Microdialysis, Neuron-specific enolase, Outcome, S-100B, Traumatic brain injury
Nationell ämneskategori
Anestesi och intensivvård Neurologi
Identifikatorer
URN: urn:nbn:se:umu:diva-190875DOI: 10.1007/s12028-021-01412-zISI: 000730887100001PubMedID: 34914037Scopus ID: 2-s2.0-85121453398OAI: oai:DiVA.org:umu-190875DiVA, id: diva2:1623508
Forskningsfinansiär
KempestiftelsernaTore Nilsons Stiftelse för medicinsk forskningRegion VästerbottenTillgänglig från: 2021-12-29 Skapad: 2021-12-29 Senast uppdaterad: 2023-03-24Bibliografiskt granskad

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Olivecrona, MagnusKoskinen, Lars-Owe D.

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