| Juguloarterial endothelin-1 gradients after severe traumatic brain injury. | |
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MedLine Citation:
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PMID: 20652766 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Endothelin-1 (ET-1) is a potent vasoconstrictor and is thought to be responsible for secondary ischemia and vasogenic edema after traumatic brain injury (TBI). Both CSF and plasma concentrations have been shown to be increased after TBI, but there is little evidence to confirm an intracranial site of production. METHODS: Using paired arterial and jugular venous bulb sampling, we measured arterial and jugular levels of ET-1 and its precursor, big endothelin (Big ET), and calculated juguloarterial (JA) gradients for the first 5 days post-TBI. RESULTS: Arterial levels of both Big ET and ET-1 were maximal on day 1 post-TBI, and decreased thereafter (P < 0.05). Arterial levels of Big ET and ET-1 showed correlation across all 5 days of the study (r (2) = 0.25, P < 0.001). While there was no significant JA gradient for Big ET, significant gradients were observed for ET-1 on days 1-4 post-TBI (P < 0.05). There was no correlation between JA gradients for Big ET and ET-1 (r (2) < 0.1, P > 0.9). These data suggest parenchymal production of ET-1 by brain tissue with spill over into the blood, rather than local intraluminal cleavage of Big ET in the cerebral vasculature. Systemic ET-1 levels and JA gradients of ET-1 were unrelated to the injury severity, APACHE II score, Marshall Grade, the presence of subarachnoid or subdural hemorrhage, or eventual outcome. CONCLUSIONS: These findings confirm the synthesis of Big ET and its cleavage to ET-1 within the brain after TBI. More work is needed to elucidate the pathophysiological role and the outcome impact of ET-1 generation after TBI. |
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Authors:
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Doris A Chatfield; Darshan H Brahmbhatt; Tilly Sharp; Iain E Perkes; Joanne G Outrim; David K Menon |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurocritical care Volume: 14 ISSN: 1556-0961 ISO Abbreviation: Neurocrit Care Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 55-60 Citation Subset: IM |
Affiliation:
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Division of Anaesthesia, Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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