Extracellular glycerol in patients with severe traumatic brain injury

• Published in: Chinese journal of traumatology 2008-04, Vol.11 (2), p.84-88
• Main Author: 李爱林 只达石 王琼 黄惠玲
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biomarkers - analysis; Brain Chemistry; Brain Injuries - diagnostic imaging; Brain Injuries - metabolism; Extracellular Space - chemistry; Female; Glycerol; Glycerol - analysis; Humans; Male; Microdialysis; Middle Aged; Retrospective Studies; Tomography, X-Ray Computed; Traumatic brain injury; 丙三醇; 治疗方法
• ISSN: 1008-1275
• DOI: 10.1016/S1008-1275(08)60018-8

Objective： To study the factors affecting extracellular glycerol （Gly） in patients with severe traumatic brain injury （STBI）. Methods： Perilesional extracellular Gly and cerebral blood flow （CBF） in 53 patients with STBI were consecutively monitored. Simultaneously, the intracranial pressure （ICP） and cerebral perfusion pressure （CCP） were monitored. The hourly minimum of CCP and CBF and the hourly maximum of ICP levels were matched with the hourly Gly. Gly values were divided into several groups according to regional ICP （〈 15 nun Hg or 〉 15 nun Hg）, CCP （〈70 nun Hg or 〉70 nun Hg）, CBF （〈50 AU or 50-150 AU） and the outcomes （death or persistent vegetative state group, severe or moderate disability group, and good recovery group）. Results： In comparison with the severe or moderate disability group, the Gly concentration of the death or persistent vegetative state group increased significantly, but CBF and CCP decreased significantly. In comparison with the good recovery group, the Gly concentration of the severe or moderate disability group increased significantly, but CBF and CCP decreased significantly. The Gly concen- trations in patients with ICP〉15 mm Hg, CCP〈70 mm Hg and CBF〈50 AU were respectively higher than those of patients with ICP 〈15 mm Hg, CCP〉70 mm Hg and 50AU 〈CBF〈150AU. In patients with diffuse axial injury, the mean Gly concentration was （201.17±55.00） μmol/L, which was significantly higher than that of the patients with epidural hematoma （n=7, 73.26±8.37, P〈O.05） or subdural hematoma （n=9, 114.67 ±62.88, P〈O.05）, but it did not increase signifi- cantly when compared with those in patients with contusion （n=24, 167.48±52.63）. Conclusion： Gly can be taken as a marker for degrada- tion of membrane phospholipids and ischemia, which reflects the severity of primary or secondary insult.