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

Tobias Clausen, Oscar Luis Alves, Michael Reinert, Egon Doppenberg, Alois Zauner, Ross Bullock

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

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 μmol/L on Day 1 to 9 ± 3 μmol/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.

Original languageEnglish
Pages (from-to)233-238
Number of pages6
JournalJournal of Neurosurgery
Volume103
Issue number2
DOIs
StatePublished - Aug 1 2005
Externally publishedYes

Fingerprint

Glycerol
Brain
Glasgow Outcome Scale
Extracellular Fluid
Microdialysis
Cerebrovascular Circulation
Traumatic Brain Injury
Wounds and Injuries
Brain Injuries
Head
Tomography
Cell Membrane

Keywords

  • Cerebral perfusion pressure
  • Glycerol
  • Microdialysis
  • Multimodal monitoring
  • Oxygenation
  • Traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

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.

In: Journal of Neurosurgery, Vol. 103, No. 2, 01.08.2005, p. 233-238.

Research output: Contribution to journalArticle

Clausen, Tobias ; Alves, Oscar Luis ; Reinert, Michael ; Doppenberg, Egon ; Zauner, Alois ; Bullock, Ross. / Association between elevated brain tissue glycerol levels and poor outcome following severe traumatic brain injury. In: Journal of Neurosurgery. 2005 ; Vol. 103, No. 2. pp. 233-238.
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