Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury : the START-TRIP study
© 2023. The Author(s)..
INTRODUCTION: Altered levels of cerebrospinal fluid (CSF) glucose and lactate concentrations are associated with poor outcomes in acute brain injury patients. However, no data on changes in such metabolites consequently to therapeutic interventions are available. The aim of the study was to assess CSF glucose-to-lactate ratio (CGLR) changes related to therapies aimed at reducing intracranial pressure (ICP).
METHODS: A multicentric prospective cohort study was conducted in 12 intensive care units (ICUs) from September 2017 to March 2022. Adult (> 18 years) patients admitted after an acute brain injury were included if an external ventricular drain (EVD) for intracranial pressure (ICP) monitoring was inserted within 24 h of admission. During the first 48-72 h from admission, CGLR was measured before and 2 h after any intervention aiming to reduce ICP ("intervention"). Patients with normal ICP were also sampled at the same time points and served as the "control" group.
RESULTS: A total of 219 patients were included. In the intervention group (n = 115, 53%), ICP significantly decreased and CPP increased. After 2 h from the intervention, CGLR rose in both the intervention and control groups, although the magnitude was higher in the intervention than in the control group (20.2% vs 1.6%; p = 0.001). In a linear regression model adjusted for several confounders, therapies to manage ICP were independently associated with changes in CGLR. There was a weak inverse correlation between changes in ICP and CGRL in the intervention group.
CONCLUSIONS: In this study, CGLR significantly changed over time, regardless of the study group. However, these effects were more significant in those patients receiving interventions to reduce ICP.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Critical care (London, England) - 27(2023), 1 vom: 31. März, Seite 130 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gouvêa Bogossian, Elisa [VerfasserIn] |
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| Links: |
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| Themen: |
33X04XA5AT |
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| Anmerkungen: |
Date Completed 04.04.2023 Date Revised 06.04.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s13054-023-04409-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM355089114 |
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| 100 | 1 | |a Gouvêa Bogossian, Elisa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury |b the START-TRIP study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 06.04.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a INTRODUCTION: Altered levels of cerebrospinal fluid (CSF) glucose and lactate concentrations are associated with poor outcomes in acute brain injury patients. However, no data on changes in such metabolites consequently to therapeutic interventions are available. The aim of the study was to assess CSF glucose-to-lactate ratio (CGLR) changes related to therapies aimed at reducing intracranial pressure (ICP) | ||
| 520 | |a METHODS: A multicentric prospective cohort study was conducted in 12 intensive care units (ICUs) from September 2017 to March 2022. Adult (> 18 years) patients admitted after an acute brain injury were included if an external ventricular drain (EVD) for intracranial pressure (ICP) monitoring was inserted within 24 h of admission. During the first 48-72 h from admission, CGLR was measured before and 2 h after any intervention aiming to reduce ICP ("intervention"). Patients with normal ICP were also sampled at the same time points and served as the "control" group | ||
| 520 | |a RESULTS: A total of 219 patients were included. In the intervention group (n = 115, 53%), ICP significantly decreased and CPP increased. After 2 h from the intervention, CGLR rose in both the intervention and control groups, although the magnitude was higher in the intervention than in the control group (20.2% vs 1.6%; p = 0.001). In a linear regression model adjusted for several confounders, therapies to manage ICP were independently associated with changes in CGLR. There was a weak inverse correlation between changes in ICP and CGRL in the intervention group | ||
| 520 | |a CONCLUSIONS: In this study, CGLR significantly changed over time, regardless of the study group. However, these effects were more significant in those patients receiving interventions to reduce ICP | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute brain injury | |
| 650 | 4 | |a Cerebrospinal fluid | |
| 650 | 4 | |a Glucose | |
| 650 | 4 | |a Intracerebral hemorrhage | |
| 650 | 4 | |a Intracranial pressure | |
| 650 | 4 | |a Lactate | |
| 650 | 4 | |a Subarachnoid hemorrhage | |
| 650 | 4 | |a Traumatic brain injury | |
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| 650 | 7 | |a 33X04XA5AT |2 NLM | |
| 650 | 7 | |a Glucose |2 NLM | |
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| 700 | 1 | |a Taleb, Chahnez |e verfasserin |4 aut | |
| 700 | 1 | |a Aspide, Raffaele |e verfasserin |4 aut | |
| 700 | 1 | |a Badenes, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Battaglini, Denise |e verfasserin |4 aut | |
| 700 | 1 | |a Bilotta, Federico |e verfasserin |4 aut | |
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| 700 | 1 | |a Caricato, Anselmo |e verfasserin |4 aut | |
| 700 | 1 | |a Castioni, Carlo Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Citerio, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Ferraro, Gioconda |e verfasserin |4 aut | |
| 700 | 1 | |a Martino, Costanza |e verfasserin |4 aut | |
| 700 | 1 | |a Melchionda, Isabella |e verfasserin |4 aut | |
| 700 | 1 | |a Montanaro, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Monleon Lopez, Berta |e verfasserin |4 aut | |
| 700 | 1 | |a Nato, Consolato Gianluca |e verfasserin |4 aut | |
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