TY - JOUR
T1 - Cortical Extracellular Sodium Transients after Human Head Injury
T2 - An Indicator of Secondary Brain Damage?
AU - Alessandri, B.
AU - Doppenberg, E.
AU - Zauner, A.
AU - Woodward, J.
AU - Young, H. F.
AU - Bullock, R.
PY - 1998
Y1 - 1998
N2 - Animal studies indicate that elevated extracellular sodium can increase glutamate-induced excitotoxicity. Therefore, we investigated the relationship between sodium and glutamate and the effect of changes in sodium concentrations on the outcome of head-injured patients. Thirty-four (34) patients were selected for this study and divided into a group of patients having episodes (≥30-min) of high sodium in dialysates (≥200 mM; HIGH, n = 11) and a group of patients having no such episodes (NORMAL, n = 23). Levels for sodium (226 ± 5.7 mM), glutamate (12.53 ± 2.2 μM) and ICP (32.2 ± 4.0mm Hg,) were relatively high during the high sodium episodes. Overall, mean values for glutamate, ICP and outcome did not differ amono both groups. The mean dialysate sodium concentration, however, was significantly higher in the HIGH (178 ± 6 mM) compared to the NORMAL group (158 ± 3 mM; p < 0.01). Spearman rank correlation between sodium and glutamate or ICP were not significant. The HIGH sodium group did not have significantly more patients with poor outcome than the NORMAL group. The results indicated sodium concentrations did not affect the outcome of head-injured patients. However, other sodium monitoring techniques are desirable to elucidate these apparent potentially major sodium transients, which we have observed in the human cortex, after severe head injury.
AB - Animal studies indicate that elevated extracellular sodium can increase glutamate-induced excitotoxicity. Therefore, we investigated the relationship between sodium and glutamate and the effect of changes in sodium concentrations on the outcome of head-injured patients. Thirty-four (34) patients were selected for this study and divided into a group of patients having episodes (≥30-min) of high sodium in dialysates (≥200 mM; HIGH, n = 11) and a group of patients having no such episodes (NORMAL, n = 23). Levels for sodium (226 ± 5.7 mM), glutamate (12.53 ± 2.2 μM) and ICP (32.2 ± 4.0mm Hg,) were relatively high during the high sodium episodes. Overall, mean values for glutamate, ICP and outcome did not differ amono both groups. The mean dialysate sodium concentration, however, was significantly higher in the HIGH (178 ± 6 mM) compared to the NORMAL group (158 ± 3 mM; p < 0.01). Spearman rank correlation between sodium and glutamate or ICP were not significant. The HIGH sodium group did not have significantly more patients with poor outcome than the NORMAL group. The results indicated sodium concentrations did not affect the outcome of head-injured patients. However, other sodium monitoring techniques are desirable to elucidate these apparent potentially major sodium transients, which we have observed in the human cortex, after severe head injury.
KW - Head injury
KW - Microdialysis
KW - Sodium transients
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U2 - 10.1007/978-3-7091-6475-4_68
DO - 10.1007/978-3-7091-6475-4_68
M3 - Article
C2 - 9779194
AN - SCOPUS:0032253005
VL - 1998
SP - 237
EP - 240
JO - Acta Neurochirurgica, Supplement
JF - Acta Neurochirurgica, Supplement
SN - 0065-1419
IS - SUPPL. 71
ER -