Association between elevated brain tissue glycerol levels and poor outcome following severe traumatic brain injury

Clausen, Tobias; Alves, Oscar Luis; Reinert, Michael; Doppenberg, Egon; Zauner, Alois; Bullock, Ross (2005). Association between elevated brain tissue glycerol levels and poor outcome following severe traumatic brain injury. Journal of neurosurgery, 103(2), pp. 233-8. Charlottesville, Va.: American Association of Neurological Surgeons 10.3171/jns.2005.103.2.0233

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OBJECT: Glycerol is considered to be a marker of cell membrane degradation and thus cellular lysis. Recently, it has become feasible to measure via microdialysis cerebral extracellular fluid (ECF) glycerol concentrations at the patient's bedside. Therefore the aim of this study was to investigate the ECF concentration and time course of glycerol after severe traumatic brain injury (TBI) and its relationship to patient outcome and other monitoring parameters. METHODS: As soon as possible after injury for up to 4 days, 76 severely head-injured patients were monitored using a microdialysis probe (cerebral glycerol) and a Neurotrend sensor (brain tissue PO2) in uninjured brain tissue confirmed by computerized tomography scanning. The mean brain tissue glycerol concentration in all monitored patients decreased significantly from 206 +/- 31 micromol/L on Day 1 to 9 +/- 3 micromol/L on Day 4 after injury (p < 0.0001). Note, however, that there was no significant difference in the time course between patients with a favorable outcome (Glasgow Outcome Scale [GOS] Scores 4 and 5) and those with an unfavorable outcome (GOS Scores 1-3). Significantly increased glycerol concentrations were observed when brain tissue PO2 was less than 10 mm Hg or when cerebral perfusion pressure was less than 70 mm Hg. CONCLUSIONS: Based on results in the present study one can infer that microdialysate glycerol is a marker of severe tissue damage, as seen immediately after brain injury or during profound tissue hypoxia. Given that brain tissue glycerol levels do not yet add new clinically significant information, however, routine monitoring of this parameter following traumatic brain injury needs further validation.

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:	0022-3085
ISBN:	16175851
Publisher:	American Association of Neurological Surgeons
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:02
Last Modified:	05 Dec 2022 14:19
Publisher DOI:	10.3171/jns.2005.103.2.0233
PubMed ID:	16175851
Web of Science ID:	000231368300007
URI:	https://boris.unibe.ch/id/eprint/27033 (FactScience: 101359)