Admission glucose and coagulopathy occurrence in patients with traumatic brain injury

Alexiou, George Α.; Lianos, Georgios D; Fotakopoulos, George; Michos, Evaggelos; Pachatouridis, Dimitrios; Voulgaris, Spyridon

doi:10.3109/02699052.2014.888769

Cited by 53 publications

(24 citation statements)

References 26 publications

(33 reference statements)

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“…While increased intestinal permeability is linked to death in critically ill patients and correlates with the severity of injury in trauma patients, it has not yet been linked to death in TBI patients ( Doig et al, 1998 ; Faries et al, 1998 ; Reintam et al, 2009 ; Tude Melo et al, 2010 ; Piton et al, 2011 ). On the other hand, patients with severe TBI have significantly higher blood glucose levels than patients with moderate or mild TBI, and hyperglycemia is highly predictive of death following TBI ( Rovlias and Kotsou, 2000 ; Salim et al, 2009 ; Tude Melo et al, 2010 ; Harun Harun et al, 2011 ; Prisco et al, 2012 ; Alexiou et al, 2014 ; Elkon et al, 2014 ; Yuan et al, 2014 ). In addition, patients with diabetes mellitus, a disease characterized by insulin resistance, have an increased risk of death following TBI ( Ley et al, 2011 ; Lustenberger et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Death following traumatic brain injury in Drosophila is associated with intestinal barrier dysfunction

Katzenberger

Chtarbanova

Rimkus

et al. 2015

eLife

123

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Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Unfavorable TBI outcomes result from primary mechanical injuries to the brain and ensuing secondary non-mechanical injuries that are not limited to the brain. Our genome-wide association study of Drosophila melanogaster revealed that the probability of death following TBI is associated with single nucleotide polymorphisms in genes involved in tissue barrier function and glucose homeostasis. We found that TBI causes intestinal and blood–brain barrier dysfunction and that intestinal barrier dysfunction is highly correlated with the probability of death. Furthermore, we found that ingestion of glucose after a primary injury increases the probability of death through a secondary injury mechanism that exacerbates intestinal barrier dysfunction. Our results indicate that natural variation in the probability of death following TBI is due in part to genetic differences that affect intestinal barrier dysfunction.DOI: http://dx.doi.org/10.7554/eLife.04790.001

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Section: Discussionmentioning

confidence: 99%

Death following traumatic brain injury in Drosophila is associated with intestinal barrier dysfunction

Katzenberger

Chtarbanova

Rimkus

et al. 2015

eLife

123

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“…In a 4-year study of 149 patients with TBI, those with severe TBI had greater admission blood glucose levels compared to those with mild TBI [27]. This initial hyperglycemia was associated with increased mortality (37% in the hyperglycemia group versus 8% in the normoglycemia group), indicating a close relationship between TBI and glucose levels [28].…”

Section: Mechanisms Of Hyperglycemia After Traumatic Brain Injury (Fimentioning

confidence: 99%

Review: Traumatic brain injury and hyperglycemia, a potentially modifiable risk factor

et al. 2016

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Hyperglycemia after severe traumatic brain injury (TBI) occurs frequently and is associated with poor clinical outcome and increased mortality. In this review, we highlight the mechanisms that lead to hyperglycemia and discuss how they may contribute to poor outcomes in patients with severe TBI. Moreover, we systematically review the proper management of hyperglycemia after TBI, covering topics such as nutritional support, glucose control, moderated hypothermia, naloxone, and mannitol treatment. However, to date, an optimal and safe glycemic target range has not been determined, and may not be safe to implement among TBI patients. Therefore, there is a mandate to explore a reasonable glycemic target range that can facilitate recovery after severe TBI.

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“…Patients with severe TBI have higher blood glucose levels than patients with moderate or mild TBI. [65][66][67][68][69] Moreover, hyperglycemia is predictive of death following TBI, [70][71][72] and patients with diabetes are at increased risk of death following TBI. 73,74 It remains to be determined whether hyperglycemia causes death following TBI and if so how.…”

Section: Glucose Ingested After Tbi Increases Death-causing Intestinamentioning

confidence: 99%

The gut reaction to traumatic brain injury

Katzenberger

Ganetzky

Wassarman

2015

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Admission glucose and coagulopathy occurrence in patients with traumatic brain injury

Abstract: Coagulopathy frequently occur after TBI. Patients with lower GCS score and lower haemoglobin levels and increased blood glucose levels at admission are at greater risk.

Cited by 53 publications

References 26 publications

Death following traumatic brain injury in Drosophila is associated with intestinal barrier dysfunction

Death following traumatic brain injury in Drosophila is associated with intestinal barrier dysfunction

Review: Traumatic brain injury and hyperglycemia, a potentially modifiable risk factor

The gut reaction to traumatic brain injury

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