Opposed effects of hypertonic saline on contusions and noncontused brain tissue in patients with severe traumatic brain injury*

Lescot, Thomas; Degos, Vincent; Zouaoui, A.; Prêteux, Françoise; Coriat, Pierre; Puybasset, Louis

doi:10.1097/01.ccm.0000243797.42346.64

Cited by 70 publications

(45 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…14,15 Nevertheless, sustained hypernatremia may be deleterious by exacerbating cerebral edema, particularly in areas where the blood-brain barrier is disrupted. 16 Furthermore, hypernatremia itself is a known risk factor for mortality in critically ill patients, 17,18 including those with TBI. 12,19,20 Commentators have expressed concerns regarding the use of HTS as a continuous infusion citing the lack of clinical evidence and the potential for harm.…”

Section: Résumémentioning

confidence: 99%

The effect of continuous hypertonic saline infusion and hypernatremia on mortality in patients with severe traumatic brain injury: a retrospective cohort study

Tan

Kolmodin

Sekhon

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose Hypertonic saline (HTS) is used to control intracranial pressure (ICP) in patients with traumatic brain injury (TBI); however, in prior studies, the resultant hypernatremia has been associated with increased mortality. We aimed to study the effect of HTS on ICP and mortality in patients with severe TBI. Methods We performed a retrospective cohort study of 231 patients with severe TBI ( [CI], 0.56 to 2.05; P = 0.84) nor hypernatremia (HR, 1.31; 95% CI, 0.68 to 2.55; P = 0.42) was associated with hospital mortality. There was no effect modification by either HTS or hypernatremia on each another. Patients who received HTS observed a significant decrease in ICP during their ICU stay compared with those who did not receive HTS (4 mmHg; 95% CI, 2 to 6; P \ 0.001 vs 2 mmHg; 95% CI, -1 to 5; P = 0.14). Conclusions Hypertonic saline and hypernatremia are not associated with hospital mortality in patients with severe TBI. RésuméObjectif Une solution saline hypertonique (HTS) est utilisée pour contrô ler la pression intracrânienne (PIC) chez les patients ayant subi un traumatisme cérébral (TC); toutefois, dans des études précédentes, l'hypernatrémie

show abstract

Section: Résumémentioning

confidence: 99%

The effect of continuous hypertonic saline infusion and hypernatremia on mortality in patients with severe traumatic brain injury: a retrospective cohort study

Tan

Kolmodin

Sekhon

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Esto ha llevado a que algunos autores lo recomendaran frente al manitol (utilización del 32% en los centros de neurocríticos de Estados Unidos). Además, aumenta el FSC y disminuye el volumen sanguíneo cerebral, aunque parece que aumen- ta el volumen del hemisferio sano 27 . La experiencia en humanos para control de la PIC inicialmente estaba limitada a pacientes en los que había fallado el manejo convencional, y distintos autores encuentran que su administración en bolo es útil para reducir la PIC resistente al manitol.…”

Section: Soluciones Osmolaresunclassified

Actualizaciones en el manejo del traumatismo craneoencefálico grave

2009

View full text Add to dashboard Cite

El traumatismo craneoencefálico (TCE) es una importante causa de morbimortalidad en cualquier lugar del mundo; afecta más a varones jóvenes y genera un problema de salud pública. Desafortunadamente, los avances en los conocimientos fisiopatológicos no han ido seguidos de similar desarrollo en las opciones terapéuticas, y no se dispone en la actualidad de fármacos neuroprotectores contrastados.En este artículo revisamos la epidemiología, la fisiopatología y las medidas terapéuticas utilizadas en el manejo del paciente con TCE grave. Se analizan tanto las medidas generales como las dirigidas al control de la hipertensión intracraneal, el papel de la cirugía y algunas opciones terapéu-ticas más innovadoras actualmente en fase de valoración en estos pacientes. UPDATES OF SEVERE TRAUMATIC BRAIN INJURY MANAGEMENT Traumatic brain injury (TBI)is an important reason of morbidity-mortality all over the world, affecting young males more and generating Public Health problem. Unfortunately, the advances in the pathophysiology knowledge have not followed a similar development in therapeutic options, there currently not being any contrasted neuroprotectants.In this article, we have reviewed the epidemiology, pathophysiology and therapeutic measures used in the management of patient with severe TBI. The general measures as well as those aimed at controlling intracranial hypertension, the role of the surgery and some more innovative therapeutic options currently under evaluation in these patients are analyzed.

show abstract

“…The principles of identifying areas of BBB compromise and edema can be translated into neuroimaging. In 2006, Lescot et al used computed tomography to measure volume, weight and specific gravity of contused and non-contused areas in patients with severe TBI [36]. Positron emission tomography (PET) can identify the injury penumbra using a metabolic strategy.…”

Section: Clinical Measurement Of Bbb Permeabilitymentioning

confidence: 99%

Assessing Blood Brain Barrier Permeability in Traumatic Brain Injury Research

et al. 2015

View full text Add to dashboard Cite

The blood brain barrier plays an important role in traumatic brain injury, serving at the crossroads of secondary injury and potential therapies. In regards to trauma, this barrier contains an array of cellular and molecular components that protect the central nervous system from derangements in water homeostasis and inflammation. Preclinical and clinical assays have been developed to describe and quantify blood brain barrier permeability in relation to the integrity of these blood brain barrier components and the handling ofedema. This review will discuss both preclinical and clinical molecular and imaging techniques that are used to assess blood brain barrier function and recovery following traumatic brain injury.

show abstract

Opposed effects of hypertonic saline on contusions and noncontused brain tissue in patients with severe traumatic brain injury*

Cited by 70 publications

References 23 publications

The effect of continuous hypertonic saline infusion and hypernatremia on mortality in patients with severe traumatic brain injury: a retrospective cohort study

The effect of continuous hypertonic saline infusion and hypernatremia on mortality in patients with severe traumatic brain injury: a retrospective cohort study

Actualizaciones en el manejo del traumatismo craneoencefálico grave

Assessing Blood Brain Barrier Permeability in Traumatic Brain Injury Research

Contact Info

Product

Resources

About