Determinants of cerebral extracellular potassium after severe human head injury

Egon M.R. Doppenberg, M. Reinert, A. Zauner, T. S. Massie, R. Bullock

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

The key role players of brain swelling seen after severe human head injury have only been partly determined. We used our human head injury data base to determine relationships between potassium, glutamate, lactate and cerebral blood flow (CBF). A total of 70 severely head injured patients (GCS ≤ 8) were studied using intracerebral microdialysis to measure extracellular glutamate, potassium and lactate. Xenon CT was used to determine regional cerebral blood flow (rCBF). The mean ± SEM of the r value of all patients, between potassium and glutamate, and potassium and lactate was 0.25 ± 0.04 (p < 0.0001) and 0.17 ± 0.06 (p = 0.006), respectively, demonstrating in both cases a positive relationship. rCBF was negatively correlated with potassium with marginal significance (r = 0.35, p = 0.08). When separated into two groups, patients with contusion had higher potassium levels than patients without contusion (1.55 ± 0.03 mmol/l versus 1.26 ± 0.02 mmol/l, respectively). These results in severely head injured patients confirm previous in vitro and animal studies in which relationships between potassium, glutamate, lactate and CBF were found. Potassium efflux is a major determinant of cell swelling leading to clinically significant cytotoxic edema due to increased glutamate release during reduced cerebral blood flow.

Original languageEnglish (US)
Pages (from-to)31-34
Number of pages4
JournalActa Neurochirurgica, Supplement
Volume1999
Issue numberSUPPL. 75
DOIs
StatePublished - Jan 1 1999

Keywords

  • Cerebral blood flow
  • Glutamate
  • Lactate
  • Potassium
  • Severe human head injury

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Neurology

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    Doppenberg, E. M. R., Reinert, M., Zauner, A., Massie, T. S., & Bullock, R. (1999). Determinants of cerebral extracellular potassium after severe human head injury. Acta Neurochirurgica, Supplement, 1999(SUPPL. 75), 31-34. https://doi.org/10.1007/978-3-7091-6415-0_7