OBJECT: Oxygen supply to the brain is often insufficient after traumatic brain injury (TBI), and this results in decreased energy production (adenosine triphosphate [ATP]) with consequent neuronal cell death. It is obviously important to restore oxygen delivery after TBI; however, increasing oxygen delivery alone may not improve ATP production if the patient's mitochondria (the source of ATP) are impaired. Traumatic brain injury has been shown to impair mitochondrial function in animals; however, no human studies have been previously reported. METHODS: Using tissue fractionation procedures, living mitochondria derived from therapeutically removed brain tissue were analyzed in 16 patients with head injury (Glasgow Coma Scale Scores 3-14) and two patients without head injury. Results revealed that in head-injured patients mitochondrial function was impaired, with subsequent decreased ATP production. CONCLUSIONS: Decreased oxygen metabolism due to mitochondrial dysfunction must be taken into account when clinically defining ischemia and interpreting oxygen measurements such as jugular venous oxygen saturation, arteriovenous difference in oxygen content, direct tissue oxygen tension, and cerebral blood oxygen content determined using near-infrared spectroscopy. Restoring mitochondrial function might be as important as maintaining oxygen delivery.
OBJECT: Oxygen supply to the brain is often insufficient after traumatic brain injury (TBI), and this results in decreased energy production (adenosine triphosphate [ATP]) with consequent neuronal cell death. It is obviously important to restore oxygen delivery after TBI; however, increasing oxygen delivery alone may not improve ATP production if the patient's mitochondria (the source of ATP) are impaired. Traumatic brain injury has been shown to impair mitochondrial function in animals; however, no human studies have been previously reported. METHODS: Using tissue fractionation procedures, living mitochondria derived from therapeutically removed brain tissue were analyzed in 16 patients with head injury (Glasgow Coma Scale Scores 3-14) and two patients without head injury. Results revealed that in head-injured patients mitochondrial function was impaired, with subsequent decreased ATP production. CONCLUSIONS: Decreased oxygen metabolism due to mitochondrial dysfunction must be taken into account when clinically defining ischemia and interpreting oxygen measurements such as jugular venous oxygen saturation, arteriovenous difference in oxygen content, direct tissue oxygen tension, and cerebral blood oxygen content determined using near-infrared spectroscopy. Restoring mitochondrial function might be as important as maintaining oxygen delivery.
Authors: Javad T Hashmi; Ying-Ying Huang; Bushra Z Osmani; Sulbha K Sharma; Margaret A Naeser; Michael R Hamblin Journal: PM R Date: 2010-12 Impact factor: 2.298
Authors: Margaret A Naeser; Anita Saltmarche; Maxine H Krengel; Michael R Hamblin; Jeffrey A Knight Journal: Photomed Laser Surg Date: 2010-12-23 Impact factor: 2.796
Authors: Rebecca L Smith; John C Lin; P David Adelson; Patrick M Kochanek; Ericka L Fink; Stephen R Wisniewski; Hülya Bayir; Elizabeth C Tyler-Kabara; Robert S B Clark; S Danielle Brown; Michael J Bell Journal: Pediatr Crit Care Med Date: 2012-01 Impact factor: 3.624
Authors: Delphine Feuerstein; Andrew Manning; Parastoo Hashemi; Robin Bhatia; Martin Fabricius; Christos Tolias; Clemens Pahl; Max Ervine; Anthony J Strong; Martyn G Boutelle Journal: J Cereb Blood Flow Metab Date: 2010-02-10 Impact factor: 6.200