BACKGROUND: Increased blood glucose and impaired pressure reactivity (PRx) after traumatic brain injury (TBI) are both known to correlate with unfavorable patient outcome. However, the relationship between these two variables is unknown. METHODS: To test the hypothesis that increased blood glucose leads to increased PRx, we retrospectively analyzed data from 86 traumatic brain injured patients admitted to the Neurocritical Care Unit. Data analyzed included arterial glucose concentration, intracranial pressure (ICP), cerebral perfusion pressure (CPP) and end-tidal CO2. PRx was calculated as the moving correlation coefficient between averaged (10 seconds) arterial blood pressure and ICP. One arterial glucose concentration and one time-aligned PRx value were obtained for each patient, during each day until the fifth day after ictus. RESULTS: Mean arterial glucose concentrations during the first 5 days since ictus were positively correlated with mean PRx (Pearson correlation coefficient = 0.25, p = 0.02). The correlation was strongest on the first day after injury (Pearson correlation coefficient = 0.47, p = 0.008). CONCLUSION: Our preliminary findings indicate that increased blood glucose may impair cerebrovascular reactivity, potentially contributing to a mechanistic link between increased blood glucose and poorer outcome after TBI.
BACKGROUND: Increased blood glucose and impaired pressure reactivity (PRx) after traumatic brain injury (TBI) are both known to correlate with unfavorable patient outcome. However, the relationship between these two variables is unknown. METHODS: To test the hypothesis that increased blood glucose leads to increased PRx, we retrospectively analyzed data from 86 traumatic brain injured patients admitted to the Neurocritical Care Unit. Data analyzed included arterial glucose concentration, intracranial pressure (ICP), cerebral perfusion pressure (CPP) and end-tidal CO2. PRx was calculated as the moving correlation coefficient between averaged (10 seconds) arterial blood pressure and ICP. One arterial glucose concentration and one time-aligned PRx value were obtained for each patient, during each day until the fifth day after ictus. RESULTS: Mean arterial glucose concentrations during the first 5 days since ictus were positively correlated with mean PRx (Pearson correlation coefficient = 0.25, p = 0.02). The correlation was strongest on the first day after injury (Pearson correlation coefficient = 0.47, p = 0.008). CONCLUSION: Our preliminary findings indicate that increased blood glucose may impair cerebrovascular reactivity, potentially contributing to a mechanistic link between increased blood glucose and poorer outcome after TBI.
Authors: Paul Vespa; David L McArthur; Nathan Stein; Sung-Cheng Huang; Weber Shao; Maria Filippou; Maria Etchepare; Thomas Glenn; David A Hovda Journal: Crit Care Med Date: 2012-06 Impact factor: 7.598
Authors: Jackelien G M Van Beek; Nino A Mushkudiani; Ewout W Steyerberg; Isabella Butcher; Gillian S McHugh; Juan Lu; Anthony Marmarou; Gordon D Murray; Andrew I R Maas Journal: J Neurotrauma Date: 2007-02 Impact factor: 5.269
Authors: Kathleen A Page; Owen Chan; Jagriti Arora; Renata Belfort-Deaguiar; James Dzuira; Brian Roehmholdt; Gary W Cline; Sarita Naik; Rajita Sinha; R Todd Constable; Robert S Sherwin Journal: JAMA Date: 2013-01-02 Impact factor: 56.272
Authors: Tracey A Baird; Mark W Parsons; Thanh Phan; Thanh Phanh; Ken S Butcher; Patricia M Desmond; Brian M Tress; Peter G Colman; Brian R Chambers; Stephen M Davis Journal: Stroke Date: 2003-07-31 Impact factor: 7.914
Authors: Pedro Diaz-Parejo; Nils Ståhl; Wangbin Xu; Peter Reinstrup; Urban Ungerstedt; Carl-Henrik Nordström Journal: Intensive Care Med Date: 2003-03-25 Impact factor: 17.440
Authors: Joseph Donnelly; Marek Czosnyka; Hadie Adams; Chiara Robba; Luzius A Steiner; Danilo Cardim; Brenno Cabella; Xiuyun Liu; Ari Ercole; Peter John Hutchinson; David Krishna Menon; Marcel J H Aries; Peter Smielewski Journal: Crit Care Med Date: 2017-09 Impact factor: 7.598
Authors: Keri L H Carpenter; Marek Czosnyka; Ibrahim Jalloh; Virginia F J Newcombe; Adel Helmy; Richard J Shannon; Karol P Budohoski; Angelos G Kolias; Peter J Kirkpatrick; Thomas Adrian Carpenter; David K Menon; Peter J Hutchinson Journal: Front Neurol Date: 2015-02-18 Impact factor: 4.003
Authors: Hadie Adams; Joseph Donnelly; Marek Czosnyka; Angelos G Kolias; Adel Helmy; David K Menon; Peter Smielewski; Peter J Hutchinson Journal: PLoS Med Date: 2017-07-25 Impact factor: 11.069
Authors: Teodor Svedung Wettervik; Anders Hånell; Timothy Howells; Elisabeth Ronne-Engström; Per Enblad; Anders Lewén Journal: J Intensive Care Med Date: 2022-02-16 Impact factor: 2.889
Authors: Adam M H Young; Hadie Adams; Joseph Donnelly; Mathew R Guilfoyle; Helen Fernandes; Mathew R Garnett; Marek Czosnyka; Peter Smielewski; Mark Plummer; Shruti Agrawal; Peter J Hutchinson Journal: Front Pediatr Date: 2017-09-25 Impact factor: 3.418