Association between elevated brain tissue glycerol levels and poor outcome following severe traumatic brain injury

Abstract

Based on results in the present study one can infer that microdialysate glycerol is a marker of severe tissue damage, as seen immediately after brain injury or during profound tissue hypoxia. Given that brain tissue glycerol levels do not yet add new clinically significant information, however, routine monitoring of this parameter following traumatic brain injury needs further validation.

Continuous monitoring of cerebral metabolism in traumatic brain injury: a focus on cerebral microdialysis

“…There is some concern that other sources of increased cerebral glycerol, such as spill over from the systemic pool of glycerol and formation of glycerol from glucose, may play a role. In this context, a recent study by Clausen et al [9 ] is an important contribution. The authors studied the relationships between brain interstitial glycerol, PbtO 2 , cerebral perfusion pressure (CPP) and outcome [3-month Glasgow Outcome Scale (GOS) score] in a large cohort of 76 patients with severe TBI.…”

Quantitation of Ischemic Events After Severe Traumatic Brain Injury in Humans: A Simple Scoring System

“…16,17,38 Elevation of microdialysate glutamate may occur especially after TBI, subarachnoid hemorrhage, and stroke, and it has been correlated with unfavorable outcome. 16,32,39,40 Glycerol is a relatively new analyte, which has been less studied [41][42][43][44] and more studies are required before definitive conclusions can be drawn about its value.…”

Cerebral Microdialysis: Research Technique or Clinical Tool?

“…43 Cerebral MD glycerol concentrations are typically elevated in the first 24 hours after severe TBI, presumably as a result of the primary injury, and then exponentially decline during the ensuing 3 days. 9 Subsequent increases in MD glycerol concentration are associated with adverse secondary events 37 and seizure activity.…”

“…28 In a recent study, Clausen et al examined the relationship between PbtO 2 , MD glycerol, CPP and outcome in 76 patients with severe TBI. 9 Although PbtO 2 < 1.3 kPa and CPP < 70 mmHg were associated with elevated mean cerebral MD glycerol levels, individual episodes below the same thresholds were frequently recorded without an increase in MD glycerol concentration. There was also no difference in mean MD glycerol concentrations between patients with favourable and unfavourable outcomes.…”