| Monitoring of glucose in brain, adipose tissue, and peripheral blood in patients with traumatic brain injury: a microdialysis study. | |
| | |
MedLine Citation:
|
PMID: 21722575 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Episodes of hyperglycemia are considered to be a secondary insult in traumatically brain-injured patients and have been shown to be associated with impaired outcome. Intensive insulin therapy to maintain a strict glucose level has been suggested to decrease morbidity and mortality in critically ill patients but this aggressive insulin treatment has been challenged. One aspect of strict glucose control is the risk of developing hypoglycemia. Extracellular intracerebral hypoglycemia monitored by intracerebral microdialysis has been shown to correlate with poor outcome. Monitoring of blood glucose during neurointensive care is important because adequate glucose supply from the systemic circulation is crucial to maintain the brain's glucose demand after brain injury. This study investigates the correlation of glucose levels in peripheral blood, subcutaneous (SC) fat, and extracellular intracerebral tissue in patients with severe traumatic brain injury during neurointensive care. METHODS: In this study, we included 12 patients with severe traumatic brain injury. All patients received one microdialysis catheter each, with a membrane length of 10 mm (CMA 70, CMA Microdialysis AB) in the injured hemisphere of the brain and in the noninjured hemisphere of the brain. An additional microdialysis catheter with a membrane length of 30 mm (CMA 60, CMA Microdialysis AB) was placed in the periumbilical subcutaneous adipose tissue. We studied the correlation among levels of glucose measured in peripheral blood, adipose tissue, and the noninjured hemisphere of the brain during the first 12 hours and during 3 consecutive days in neurointensive care. RESULTS: We found a significant positive correlation between levels of glucose in peripheral blood, SC fat, and the noninjured brain during the initial 12 hours but not in injured brain. However, the result varied between the patients during the 3-day measurements. In 7 patients, there was a significant positive correlation between glucose in blood and noninjured brain, while in 4 patients this correlation was poor. In 4 patients, there was a significant positive correlation in injured brain and blood. Furthermore, there was a significant correlation between brain and adipose tissue glucose during the 3-day measurements in 11 out of 12 patients. CONCLUSION: This study indicates that there is a good correlation between blood glucose and adipose tissue during initial and later time points in the neurointensive care unit whereas the correlation between blood and brain seems to be more individualized among patients. This emphasizes the importance of using intracerebral microdialysis to ensure adequate intracerebral levels of glucose in patients suffering from severe traumatic brain injury and to detect hypoglycemia in the brain despite normal levels of blood glucose. |
| | |
Authors:
|
Elham Rostami; Bo-Michael Bellander |
Related Documents
:
|
21689195 - The relationship between serious injury and blood alcohol concentration (bac) in fatal ... 16995465 - The effects of occlusive techniques on the short-term prognosis after liver resections. 10343325 - Regional metabolic disturbances and cerebrovascular anatomy after permanent middle cere... 9116355 - Setting roller pump occlusion with the transonic ht109 flowmeter. 22498235 - Identification of nasal blood by real-time rt-pcr. 8053525 - Preoperatively assessing and planning blood use for elective vascular surgery. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-05-01 |
Journal Detail:
|
Title: Journal of diabetes science and technology Volume: 5 ISSN: 1932-2968 ISO Abbreviation: J Diabetes Sci Technol Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-07-04 Completed Date: 2012-03-25 Revised Date: 2012-05-01 |
Medline Journal Info:
|
Nlm Unique ID: 101306166 Medline TA: J Diabetes Sci Technol Country: United States |
Other Details:
|
Languages: eng Pagination: 596-604 Citation Subset: IM |
Copyright Information:
|
© 2011 Diabetes Technology Society. |
Affiliation:
|
Department of Neuroscience, Karolinska University Hospital Solna, Karolinska Institute, Stockholm, Sweden. elham.rostami@ki.se |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adipose Tissue
/
metabolism* Blood Glucose / metabolism Blood Glucose Self-Monitoring / methods* Brain / blood supply, metabolism* Brain Injuries / metabolism* Female Glucose / metabolism* Humans Hypoglycemia / metabolism Intensive Care Male Microdialysis / methods* Monitoring, Physiologic Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Blood Glucose; 50-99-7/Glucose |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Metabolic biofouling of glucose sensors in vivo: role of tissue microhemorrhages.
Next Document: Implant healing in experimental animal models of diabetes.