Determinants of cerebral extracellular potassium after severe human head injury

Doppenberg, E M; Reinert, M; Zauner, A; Massie, T S; Bullock, R (1999). Determinants of cerebral extracellular potassium after severe human head injury. Acta neurochirurgica - supplementa, 75(75), pp. 31-34. Wien: Springer 10.1007/978-3-7091-6415-0_7

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The key role players of brain swelling seen after severe human head injury have only been partly determined. We used our human head injury data base to determine relationships between potassium, glutamate, lactate and cerebral blood flow (CBF). A total of 70 severely head injured patients (GCS < or = 8) were studied using intracerebral microdialysis to measure extracellular glutamate, potassium and lactate. Xenon CT was used to determine regional cerebral blood flow (rCBF). The mean +/- SEM of the r value of all patients, between potassium and glutamate, and potassium and lactate was 0.25 +/- 0.04 (p < 0.0001) and 0.17 +/- 0.06 (p = 0.006), respectively, demonstrating in both cases a positive relationship. rCBF was negatively correlated with potassium with marginal significance (r = -0.35, p = 0.08). When separated into two groups, patients with contusion had higher potassium levels than patients without contusion (1.55 +/- 0.03 mmol/l versus 1.26 +/- 0.02 mmol/l, respectively). These results in severely head injured patients confirm previous in vitro and animal studies in which relationships between potassium, glutamate, lactate and CBF were found. Potassium efflux is a major determinant of cell swelling leading to clinically significant cytotoxic edema due to increased glutamate release during reduced cerebral blood flow.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Reinert, Michael

ISSN:

0065-1419

ISBN:

10635373

Publisher:

Springer

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:02

Last Modified:

23 Jan 2020 14:36

Publisher DOI:

10.1007/978-3-7091-6415-0_7

PubMed ID:

10635373

BORIS DOI:

10.7892/boris.27055

URI:

https://boris.unibe.ch/id/eprint/27055 (FactScience: 101413)

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