Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13054-023-04409-6 |
| _version_ | 1797853811190005760 |
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| author | Elisa Gouvêa Bogossian Chahnez Taleb Raffaele Aspide Rafael Badenes Denise Battaglini Federico Bilotta Aaron Blandino Ortiz Anselmo Caricato Carlo Alberto Castioni Giuseppe Citerio Gioconda Ferraro Costanza Martino Isabella Melchionda Federica Montanaro Berta Monleon Lopez Consolato Gianluca Nato Michael Piagnerelli Edoardo Picetti Chiara Robba Olivier Simonet Aurelie Thooft Fabio Silvio Taccone |
| author_facet | Elisa Gouvêa Bogossian Chahnez Taleb Raffaele Aspide Rafael Badenes Denise Battaglini Federico Bilotta Aaron Blandino Ortiz Anselmo Caricato Carlo Alberto Castioni Giuseppe Citerio Gioconda Ferraro Costanza Martino Isabella Melchionda Federica Montanaro Berta Monleon Lopez Consolato Gianluca Nato Michael Piagnerelli Edoardo Picetti Chiara Robba Olivier Simonet Aurelie Thooft Fabio Silvio Taccone |
| author_sort | Elisa Gouvêa Bogossian |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-09T19:55:39Z |
| format | Article |
| id | doaj.art-c2ed81f5c0274e3283204443d4d5c798 |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-04-09T19:55:39Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-c2ed81f5c0274e3283204443d4d5c7982023-04-03T05:28:35ZengBMCCritical Care1364-85352023-03-0127111110.1186/s13054-023-04409-6Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP studyElisa Gouvêa Bogossian0Chahnez Taleb1Raffaele Aspide2Rafael Badenes3Denise Battaglini4Federico Bilotta5Aaron Blandino Ortiz6Anselmo Caricato7Carlo Alberto Castioni8Giuseppe Citerio9Gioconda Ferraro10Costanza Martino11Isabella Melchionda12Federica Montanaro13Berta Monleon Lopez14Consolato Gianluca Nato15Michael Piagnerelli16Edoardo Picetti17Chiara Robba18Olivier Simonet19Aurelie Thooft20Fabio Silvio Taccone21Department of Intensive Care, Erasme University Hospital, Université Libre de BruxellesDepartment of Intensive Care, Erasme University Hospital, Université Libre de BruxellesAnesthesia and Neurointensive Care Unit, IRCCS Istituto Delle Scienze Neurologiche di BolognaDepartment of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Clínic Universitari de Valencia, University of ValenciaDepartment of Surgical Science and Integrated Diagnostic, University of GenoaDepartment of Anaesthesiology, Critical Care and Pain Medicine, Umberto I Policlinico Di RomaDepartment of Intensive Care Unit, Ramón y Cajal University HospitalIntensive Care Unit, Department of Anesthesiology and Intensive Care Medicine, Gemelli Hospital, Sacro Cuore Catholic UniversityAnesthesia and Neurointensive Care Unit, IRCCS Istituto Delle Scienze Neurologiche di BolognaScuola di Medicina e Chirurgia, Azienda Socio Sanitaria Territoriale Monza, Università Milano BicoccaDepartment of Intensive Care, Erasme University Hospital, Université Libre de BruxellesAnesthesia and Intensive Care Unit, Azienda Romagna, M. Bufalini HospitalDepartment of Anaesthesiology, Critical Care and Pain Medicine, Umberto I Policlinico Di RomaDepartment of Intensive Care, Erasme University Hospital, Université Libre de BruxellesDepartment of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Clínic Universitari de Valencia, University of ValenciaDepartment of Anaesthesiology, Critical Care and Pain Medicine, Umberto I Policlinico Di RomaDepartment of Intensive Care, CHU-Charleroi, Université Libre de BruxellesDepartment of Anesthesia and Intensive Care, Parma University HospitalDepartment of Surgical Science and Integrated Diagnostic, University of GenoaDepartment of Anaesthesia and Intensive Care, Centre Hospitalier de Wallonie PicardeDepartment of Intensive Care, CHU-Charleroi, Université Libre de BruxellesDepartment of Intensive Care, Erasme University Hospital, Université Libre de BruxellesAbstract 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.https://doi.org/10.1186/s13054-023-04409-6Acute brain injurySubarachnoid hemorrhageTraumatic brain injuryIntracerebral hemorrhageLactateGlucose |
| spellingShingle | Elisa Gouvêa Bogossian Chahnez Taleb Raffaele Aspide Rafael Badenes Denise Battaglini Federico Bilotta Aaron Blandino Ortiz Anselmo Caricato Carlo Alberto Castioni Giuseppe Citerio Gioconda Ferraro Costanza Martino Isabella Melchionda Federica Montanaro Berta Monleon Lopez Consolato Gianluca Nato Michael Piagnerelli Edoardo Picetti Chiara Robba Olivier Simonet Aurelie Thooft Fabio Silvio Taccone Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study Critical Care Acute brain injury Subarachnoid hemorrhage Traumatic brain injury Intracerebral hemorrhage Lactate Glucose |
| title | Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study |
| title_full | Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study |
| title_fullStr | Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study |
| title_full_unstemmed | Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study |
| title_short | Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study |
| title_sort | cerebro spinal fluid glucose and lactate concentrations changes in response to therapies in patients with primary brain injury the start trip study |
| topic | Acute brain injury Subarachnoid hemorrhage Traumatic brain injury Intracerebral hemorrhage Lactate Glucose |
| url | https://doi.org/10.1186/s13054-023-04409-6 |
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