Intestinal barrier dysfunction following traumatic brain injury

Pan, Pengfei; Song, Yunlin; Du, Xinxin; Bai, Linlin; Hua, Xiaoli; Xiao, Yawen; Yu, Xiangyou

doi:10.1007/s10072-019-03739-0

Cited by 37 publications

(26 citation statements)

References 44 publications

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“…After the central nervous system is damaged, various pathways in the brain-gut axis are blocked, and many brain-gut peptides are secreted abnormally. These pathways and peptides cannot transmit information normally or stimulate gastrointestinal motility [11][12][13]. The gastrointestinal mucosa is in a state of hypoperfusion, resulting in the spread of focal small ulcers, which usually manifests as stress ulcers.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of secondary gastrointestinal dysfunction increased with injury severity, and the GIF score on the rst day and the mean GIF score for the rst three days were signi cantly different among the severe, moderate and mild groups. The intestinal mucosa morphology was found to change within a short time after trauma, including epithelial cell detachment and apoptosis, rupture of the villi, edema of interstitial tissue and the lamina propria, interruption of tight junctions, etc., and the mucosal barrier was observed to have lost its protective function [11]. Additionally, the intestinal ora was completely disordered within a few hours after injury, and the microbial composition and relative abundance changed signi cantly.…”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Zhou

Lü

Tang³

2021

Preprint

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Purposes: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. Methods: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were retrospectively analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. Results: The percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4% and 21.8% of the patients, respectively. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); these scores were also significantly different between patients who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. Conclusion: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Zhou

Lü

Tang³

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The causes of these ndings were analyzed. It was found that the intestinal mucosa morphology had changed within a short time after trauma, including epithelial cell detachment and apoptosis, rupture of the villi, edema of interstitial tissue and the lamina propria, interruption of tight junctions, etc., and that the mucosal barrier had lost its protective function [11] . Additionally, the intestinal ora was completely disordered within a few hours after injury, and the microbial composition and relative abundance changed signi cantly.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Zhou

Lü

Tang

2020

Preprint

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PurposesTo review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function.MethodsA total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and 2019 were retrospectively analyzed. Admission parameters were sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). In order to predict outcome, Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS) and mean GIF score for the first three days were also combined.ResultsThe percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) developed in 36.4% and intra-abdominal hypertension (IAH) in 21.8% of patients. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); they were also significantly different between those who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children.ConclusionThe incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has its ability to judge gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

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“…Furthermore, the hemorrhagic shock is associated with barrier dysfunction of the gut and development of MODS after the trauma and can lead to a traumatic endotheliopathy by glycocalyx degradation, like in the CNS [50]. Studies have shown that paracellular hyperpermeability due to inflammatory reactions and abnormal release of neurotransmitters is the basis for intestinal barrier dysfunction after TBI [51]. The increased permeability of the organ barriers allows metabolites to enter the bloodstream and to detect specific biomarkers [14].…”

Section: Severe Traumatic Brain Injury (Tbi) Modulates Kinetic Profilmentioning

confidence: 99%

Severe Traumatic Brain Injury (TBI) Modulates the Kinetic Profile of the Inflammatory Response of Markers for Neuronal Damage

Schindler

Lustenberger

Woschek

et al. 2020

JCM

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The inflammatory response plays an important role in the pathophysiology of multiple injuries. This study examines the effects of severe trauma and inflammatory response on markers of neuronal damage. A retrospective analysis of prospectively collected data in 445 trauma patients (Injury Severity Score (ISS) ≥ 16) is provided. Levels of neuronal biomarkers (calcium-binding Protein B (S100b), Enolase2 (NSE), glial fibrillary acidic protein (GFAP)) and Interleukins (IL-6, IL-10) in severely injured patients (with polytrauma (PT)) without traumatic brain injury (TBI) or with severe TBI (PT+TBI) and patients with isolated TBI (isTBI) were measured upon arrival until day 5. S100b, NSE, GFAP levels showed a time-dependent decrease in all cohorts. Their expression was higher after multiple injuries (p = 0.038) comparing isTBI. Positive correlation of marker level after concomitant TBI and isTBI (p = 0.001) was noted, while marker expression after PT appears to be independent. Highest levels of IL-6 and -10 were associated to PT und lowest to isTBI (p < 0.001). In all groups pro-inflammatory response (IL-6/-10 ratio) peaked on day 2 and at a lower level on day 4. Severe TBI modulates kinetic profile of inflammatory response by reducing interleukin expression following trauma. Potential markers for neuronal damage have a limited diagnostic value after severe trauma because undifferentiated increase.

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Intestinal barrier dysfunction following traumatic brain injury

Cited by 37 publications

References 44 publications

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Severe Traumatic Brain Injury (TBI) Modulates the Kinetic Profile of the Inflammatory Response of Markers for Neuronal Damage

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