Alterations of the basal serum insulin and blood glucose in brain-injured patients

Pentelényi, T; Kammerer, L; Stützel, M; Balázsi, I

doi:10.1016/0020-1383(79)90009-3

Cited by 24 publications

(8 citation statements)

References 11 publications

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“…We did not enter perioperative fluid administered and presence of any SDH into the final multivariate analysis model because there were large numbers of missing data (29 missing data) for perioperative fluid, and every patient who had multiple lesions had SDH. On the other hand, hyperglycemia may exacerbate the impact of ischemia and hypoxia and lead to poor outcome22, 23 by potentiating brain cellular and tissue lactic acidosis 6, 7, 24–26…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Perioperative Hyperglycemia in Children with Traumatic Brain Injury

Sharma¹,

Jelacic²,

Chennuri³

et al. 2009

Anesthesia &Amp; Analgesia

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Background Hyperglycemia after traumatic brain injury (TBI) is associated with poor outcome. This study examined the incidence and risk factors for perioperative hyperglycemia in children with TBI. Methods A retrospective cohort study of children ≤ 13 years who underwent urgent or emergent craniotomy for TBI at Harborview Medical Center (level I Adult and Pediatric Trauma Center) between 1994 and 2004 was performed. Preoperative (Emergency department to general anesthesia start), intraoperative (during general anesthesia), and immediate postoperative (first 24 hours after surgery) glucose values for each patient were retrieved. The incidence of hyperglycemia (glucose ≥ 200 mg/dL) and hypoglycemia (glucose < 60 mg/dL) was determined. Persistent hyperglycemia was defined as hyperglycemia during any 2/3 (preoperative, intraoperative and immediate postoperative) study periods whereas transient hyperglycemia was defined as hyperglycemia during any one study period. Multivariate logistic regression analysis was used to determine the independent predictors of perioperative hyperglycemia. Data are presented as AOR (95% CI) and p < 0.05 reflects significance. Results At-least one serum glucose value was recorded during each study period: preoperative (86 [82%]), intraoperative (94 [89%]), and postoperative (101 [97%]. Sixty four percent of children had less than one glucose recorded per anesthetic hour. Forty-seven (45%) children had hyperglycemia during at least one study period. Transient hyperglycemia occurred in 29 (28%) and persistent hyperglycemia occurred in 18 (17%) of children. Independent predictors of perioperative hyperglycemia were age < 4 years (AOR [95% CI]; 3.5 [1.2–10.6]), GCS ≤ 8 (AOR 95% CI; 7.2 (2.4–21.5)) and the presence of multiple lesions including SDH (AOR 95% CI; 34.7 [2.3– 525.5]). Six children were treated with insulin, and 2 children had hypoglycemia, unrelated to insulin treatment. Conclusions Perioperative hyperglycemia was common and intraoperative hypoglycemia was not rare but more frequent intraoperative glucose sampling may be needed to better determine the incidence of hypo and hyperglycemia during the perioperative period. Age < 4 years, severe TBI and the presence of multiple lesions including SDH were risk factors for perioperative hyperglycemia.

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Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Perioperative Hyperglycemia in Children with Traumatic Brain Injury

Sharma¹,

Jelacic²,

Chennuri³

et al. 2009

Anesthesia &Amp; Analgesia

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“…2). Hyperglycemia is both a common problem (49)(50)(51)(52)(53) and strongly associated with greater mortality and worse functional outcome following ischemic stroke (54-57), intraparenchymal hemorrhage (58,59), aneurysmal subarachnoid hemorrhage (60)(61)(62), and TBI (63)(64)(65). Patients who are responsive to insulin therapy have a better prognosis than those with persistent hyperglycemia (66,67).…”

Section: Recommendationsmentioning

confidence: 98%

Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients

Jacobi

Bircher

Krinsley

et al. 2012

Critical Care Medicine

488

414

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“…Some reports described an association between insulinemia and increased mortality in head-injured patients. Both blood glucose and insulin concentration were found to be increased markedly in TBI (2,17,18). In the present study we examined serum insulin levels and we found significant increase (*) in severe head injury group when we compared with control and mild injury group.…”

Section: █ Discussionmentioning

confidence: 96%

Which biomarker is most effective to determine severity of acute head trauma in experimental animal head trauma model?

Demir

Deniz²,

Benli³

et al. 2015

Turkish Neurosurgery

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Alterations of the basal serum insulin and blood glucose in brain-injured patients

Cited by 24 publications

References 11 publications

Incidence and Risk Factors for Perioperative Hyperglycemia in Children with Traumatic Brain Injury

Incidence and Risk Factors for Perioperative Hyperglycemia in Children with Traumatic Brain Injury

Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients

Which biomarker is most effective to determine severity of acute head trauma in experimental animal head trauma model?

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