Cerebral Microdialysis Effects of Propofol versus Midazolam in Severe Traumatic Brain Injury

2012 ◽  
Vol 29 (6) ◽  
pp. 1105-1110 ◽  
Author(s):  
Michèle Tanguy ◽  
Philippe Seguin ◽  
Bruno Laviolle ◽  
Jean-Paul Bleichner ◽  
Xavier Morandi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Cerebral Microdialysis

scholarly journals Cerebral Extracellular Lactate Increase is Predominantly Nonischemic in Patients with Severe Traumatic Brain Injury

2013 ◽  
Vol 33 (11) ◽  
pp. 1815-1822 ◽  
Author(s):  
Nathalie Sala ◽  
Tamarah Suys ◽  
Jean-Baptiste Zerlauth ◽  
Pierre Bouzat ◽  
Mahmoud Messerer ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Perfusion ◽  
Cerebral Microdialysis ◽  
Lactate Metabolism ◽  
Perfusion Computed Tomography ◽  
Extracellular Lactate ◽  
Ct Brain ◽  
Brain Lactate

Growing evidence suggests that endogenous lactate is an important substrate for neurons. This study aimed to examine cerebral lactate metabolism and its relationship with brain perfusion in patients with severe traumatic brain injury (TBI). A prospective cohort of 24 patients with severe TBI monitored with cerebral microdialysis (CMD) and brain tissue oxygen tension (PbtO2) was studied. Brain lactate metabolism was assessed by quantification of elevated CMD lactate samples (>4 mmol/L); these were matched to CMD pyruvate and PbtO2 values and dichotomized as glycolytic (CMD pyruvate > 119 μmol/L vs. low pyruvate) and hypoxic (PbtO2 < 20 mm Hg vs. nonhypoxic). Using perfusion computed tomography (CT), brain perfusion was categorized as oligemic, normal, or hyperemic, and was compared with CMD and PbtO2 data. Samples with elevated CMD lactate were frequently observed (41 ±8%), and we found that brain lactate elevations were predominantly associated with glycolysis and normal PbtO2 (73 ± 8%) rather than brain hypoxia (14 ±6%). Furthermore, glycolytic lactate was always associated with normal or hyperemic brain perfusion, whereas all episodes with hypoxic lactate were associated with diffuse oligemia. Our findings suggest predominant nonischemic cerebral extracellular lactate release after TBI and support the concept that lactate may be used as an energy substrate by the injured human brain.

scholarly journals Cerebral microdialysis of interleukin (IL)-1ß and IL-6: extraction efficiency and production in the acute phase after severe traumatic brain injury in rats

2008 ◽  
Vol 150 (12) ◽  
pp. 1277-1284 ◽  
Author(s):  
Hedy Folkersma ◽  
John J. P. Brevé ◽  
Fred J. H. Tilders ◽  
Leela Cherian ◽  
Claudia S. Robertson ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Phase ◽  
Severe Traumatic Brain Injury ◽  
Extraction Efficiency ◽  
Cerebral Microdialysis

Multimodality Monitoring in Severe Traumatic Brain Injury

Neurotrauma ◽  
2019 ◽  
pp. 193-208
Author(s):  
Abdelhakim Khellaf ◽  
Peter J. A. Hutchinson ◽  
Adel Helmy
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Cerebral Perfusion ◽  
Cerebral Microdialysis ◽  
Multimodality Monitoring ◽  
Concurrent Use ◽  
Brain Tissue Oxygen Tension ◽  
Current Guidelines ◽  
The Brain

The central aspects of severe traumatic brain injury (sTBI) management are control of intracranial pressure (ICP) and maintenance of adequate delivery of glucose and oxygen to the brain. Brain multimodality monitoring (MMM) is an important tool defined by the concurrent use of multiple brain monitors, typically ICP monitoring, cerebral perfusion pressure (CPP) monitoring (via ICP and invasive arterial monitoring), brain tissue oxygen tension (PbtO2) monitoring, and cerebral microdialysis for brain biochemistry. The aim of brain MMM in patients with sTBI is to help optimize conditions for brain recovery within the neurocritical care unit, prevent secondary injury, and provide individualized therapeutic targets. In this chapter, the authors further elaborate on these concepts and current guidelines with application to a case example.

Neurocognitive status and return to work after moderate to severe traumatic brain injury.

2019 ◽  
Vol 64 (4) ◽  
pp. 435-444
Author(s):  
Tessa Hart ◽  
Jessica M. Ketchum ◽  
Therese M. O'Neil-Pirozzi ◽  
Thomas A. Novack ◽  
Doug Johnson-Greene ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Return To Work ◽  
Severe Traumatic Brain Injury

Problem-solving therapy for suicide prevention in veterans with moderate-to-severe traumatic brain injury.

2017 ◽  
Vol 62 (4) ◽  
pp. 600-608 ◽  
Author(s):  
Sean M. Barnes ◽  
Lindsey L. Monteith ◽  
Georgia R. Gerard ◽  
Adam S. Hoffberg ◽  
Beeta Y. Homaifar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Problem Solving ◽  
Suicide Prevention ◽  
Severe Traumatic Brain Injury ◽  
Problem Solving Therapy
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