• World Neurosurg · Mar 2020

    Characterization of focal brain tissue water measurements in human traumatic brain injury.

    • Bornali Kundu, Al-Wala Awad, Min S Park, Ramesh Grandhi, Toby Enniss, and Hawryluk Gregory W J GWJ Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA; Section of Neurosurgery, University of .
    • Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
    • World Neurosurg. 2020 Mar 1; 135: e271-e285.

    BackgroundCerebral edema is a major cause of morbidity in patients with severe traumatic brain injury (TBI). Intraparenchymal thermal conductivity-based probes that measure local cerebral blood flow can measure percent brain tissue water (%BTW) content, but such measures have been insufficiently characterized in patients with TBI.MethodsWe retrospectively reviewed physiologic data from patients with severe TBI treated at our institution (2014-2016) who underwent cerebral blood flow monitoring.ResultsSixteen patients underwent focal %BTW measurements at a 15-minute sampling rate. %BTW measurements showed characteristic temporal profiles, with a mean time to peak of 3.7 ± 1.7 days. The mean minimum and maximum %BTWs were 71.0 ± 3.9% and 82.7 ± 7.4%, respectively (overall mean %BTW, 77.0 ± 2.9%). Intracranial pressure (ICP) values of 22 mm Hg (the current treatment threshold for patients with trauma) corresponded to 75.8 ± 5.4 %BTW. Repeated measures correlation showed that %BTW is negatively correlated with serum sodium concentration (r = -0.3; P < 0.001) and weakly positively correlated with ICP (r = 0.08; P = 0.01) and regional cerebral blood flow (r = 0.06; P < 0.001). These effects were consistent in a multivariable model including time from injury. In the best model, time was modeled as a quadratic term because the %BTW followed a parabolic trajectory.Conclusions%BTW may be a clinically useful, real-time measurement of cerebral edema in patients with TBI. It is closely associated with the serum sodium concentration and follows a characteristic temporal course with characteristic trajectory and stability over time.Copyright © 2019 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…