The neurological wake-up test does not alter cerebral energy metabolism and oxygenation in patients with severe traumatic brain injury

Neurocritical Care

Volumn 20, Issue 3, 2014, Pages 413-426

  Skoglund, Karin ^a   Hillered, Lars ^a   Purins, Karlis ^a   Tsitsopoulos, Parmenion P ^a   Flygt, Johanna ^a   Engquist, Henrik ^a   Lewén, Anders ^a   Enblad, Per ^a   Marklund, Niklas ^a  

^a UPPSALA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Brain energy metabolism; Brain tissue oxygenation; Cerebral microdialysis; Interruption of sedation; Jugular venous oxygenation; Neurological wake up test; Traumatic brain injury

Indexed keywords

GLUCOSE; GLUTAMIC ACID; GLYCEROL; LACTIC ACID; OXYGEN; PROPOFOL; PYRUVIC ACID; HYPNOTIC SEDATIVE AGENT;

ADOLESCENT; ADULT; AGED; ARTICLE; BRAIN METABOLISM; BRAIN OXYGEN CONSUMPTION; CEREBRAL MICRODIALYSIS; CEREBRAL PERFUSION PRESSURE MONITORING; CLINICAL ARTICLE; CONSCIOUSNESS LEVEL; CONTINUOUS INFUSION; CONTROLLED STUDY; ENDOTRACHEAL INTUBATION; ENERGY METABOLISM; FEMALE; GLUCOSE BRAIN LEVEL; HUMAN; INJURY SEVERITY; INTRACRANIAL PRESSURE MONITORING; JUGULAR VENOUS OXYGEN SATURATION; MALE; MICRODIALYSIS; NEUROCHEMISTRY; NEUROLOGIC EXAMINATION; NEUROLOGICAL WAKE UP TEST; OXYGEN SATURATION; PRESSURE MEASUREMENT; PRIORITY JOURNAL; SEDATION; TISSUE OXYGENATION; TRAUMATIC BRAIN INJURY; AROUSAL; BRAIN; BRAIN INJURIES; CONSCIOUSNESS DISORDERS; INJURY SCALE; INTENSIVE CARE; INTRACRANIAL PRESSURE; JUGULAR VEIN; METABOLISM; MIDDLE AGED; PATHOPHYSIOLOGY; PHYSIOLOGICAL STRESS; PHYSIOLOGY; PROCEDURES; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; AROUSAL; BRAIN; BRAIN INJURIES; CONSCIOUSNESS DISORDERS; CRITICAL CARE; ENERGY METABOLISM; FEMALE; HUMANS; HYPNOTICS AND SEDATIVES; INTRACRANIAL PRESSURE; JUGULAR VEINS; MALE; MICRODIALYSIS; MIDDLE AGED; NEUROLOGIC EXAMINATION; OXYGEN; STRESS, PHYSIOLOGICAL; TRAUMA SEVERITY INDICES; YOUNG ADULT;

EID: 84902384968     PISSN: 15416933     EISSN: 15560961     Source Type: Journal    
DOI: 10.1007/s12028-013-9876-4     Document Type: Article

References (70)

1. Diringer MN, Edwards DF. Admission to a neurologic/neurosurgical intensive care unit is associated with reduced mortality rate after intracerebral hemorrhage. Crit Care Med. 2001;29(3):635-40. (Pubitemid 32225309)
2. Elf K, Nilsson P, Enblad P. Outcome after traumatic brain injury improved by an organized secondary insult program and standardized neurointensive care. Crit Care Med. 2002;30(9):2129-34.
3. Grande PO, Koskinen LO, Naredi S, Reinstrup P, Romner B. Conventional treatments for severe head injury: are they effective, ineffective, or even harmful? Acta Anaesthesiol Scand. 2007;51(10):1294-6. (Pubitemid 47609519)
4. Suarez JI. Outcome in neurocritical care: advances in monitoring and treatment and effect of a specialized neurocritical care team. Crit Care Med. 2006;34(9 Suppl):S232-8. (Pubitemid 44253710)
5. Varelas PN, Eastwood D, Yun HJ, et al. Impact of a neurointensivist on outcomes in patients with head trauma treated in a neurosciences intensive care unit. J Neurosurg. 2006;104(5):713-9.
6. Chesnut RM. Secondary brain insults after head injury: clinical perspectives. New Horiz. 1995;3(3):366-75.
7. Unterberg AW, Stover J, Kress B, Kiening KL. Edema and brain trauma. Neuroscience. 2004;129(4):1021-9. (Pubitemid 39556253)
8. Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728-41. (Pubitemid 351957931)
9. Stover JF. Actual evidence for neuromonitoring-guided intensive care following severe traumatic brain injury. Swiss Med Wkly. 2011;141:w13245.
10. Stuart RM, Schmidt M, Kurtz P, et al. Intracranial multimodal monitoring for acute brain injury: a single institution review of current practices. Neurocrit Care. 2010;12(2):188-98.
11. Tisdall MM, Smith M. Multimodal monitoring in traumatic brain injury: current status and future directions. Br J Anaesth. 2007;99(1):61-7. (Pubitemid 47072556)
12. Andrews PJ, Citerio G, Longhi L, Polderman K, Sahuquillo J, Vajkoczy P. NICEM consensus on neurological monitoring in acute neurological disease. Intensive Care Med. 2008;34(8):1362-70.
13. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. VI. Indications for intracranial pressure monitoring. J Neurotrauma. 2007;24(Suppl 1):S37-44.
14. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury IX cerebral perfusion thresholds. J Neurotrauma. 2007;24(Suppl 1):S59-64.
15. Hillered L, Vespa PM, Hovda DA. Translational neurochemical research in acute human brain injury: the current status and potential future for cerebral microdialysis. J Neurotrauma. 2005;22(1):3-41.
16. Hillman J, Aneman O, Anderson C, Sjogren F, Saberg C, Mellergard P. A microdialysis technique for routine measurement of macromolecules in the injured human brain. Neurosurgery. 2005;56(6):1264-8. (Pubitemid 40770444)
17. Hutchinson PJ. Microdialysis in traumatic brain injury-methodology and pathophysiology. Acta Neurochir Suppl. 2005;95:441-5.
18. Rao GS, Durga P. Changing trends in monitoring brain ischemia: from intracranial pressure to cerebral oximetry. Curr Opin Anaesthesiol. 2011;24(5):487-94.
19. Girard TD, Kress JP, Fuchs BD, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (awakening and breathing controlled trial): a randomised controlled trial 1. Lancet. 2008;371(9607):126-34.
20. Helbok R, Badjatia N. Is daily awakening always safe in severely brain injured patients? Neurocrit Care. 2009;11(2):133-4.
21. Skoglund K, Enblad P, Marklund N. Effects of the neurological wake-up test on intracranial pressure and cerebral perfusion pressure in brain-injured patients. Neurocrit Care 2009.
22. Skoglund K, Enblad P, Hillered L, Marklund N. The neurological wake-up test increases stress hormone levels in patients with severe traumatic brain injury. Crit Care Med. 2012;40(1):216-22.
23. Helbok R, Kurtz P, Schmidt MJ, et al. Effects of the neurological wake-up test on clinical examination, intracranial pressure, brain metabolism and brain tissue oxygenation in severely brain-injured patients. Crit Care. 2012;16(6):R226.
24. Howells T, Elf K, Jones PA, et al. Pressure reactivity as a guide in the treatment of cerebral perfusion pressure in patients with brain trauma. J Neurosurg. 2005;102(2):311-7. (Pubitemid 43194082)
25. Brody DL, Magnoni S, Schwetye KE, et al. Amyloid-beta dynamics correlate with neurological status in the injured human brain. Science. 2008;321(5893):1221-4.
26. Ronne-Engstrom E, Cesarini KG, Enblad P, et al. Intracerebral microdialysis in neurointensive care: the use of urea as an endogenous reference compound. J Neurosurg. 2001;94(3):397-402. (Pubitemid 32786017)
27. Hutchinson PJ, O'Connell MT, Al-Rawi PG, et al. Clinical cerebral microdialysis: a methodological study. J Neurosurg. 2000;93(1):37-43. (Pubitemid 30457321)
28. Hutchinson PJ, O'Connell MT, Nortje J, et al. Cerebral microdialysis methodology-evaluation of 20 kDa and 100 kDa catheters. Physiol Meas. 2005;26(4):423-8. (Pubitemid 40768140)
29. Purins K, Enblad P, Sandhagen B, Lewen A. Brain tissue oxygen monitoring: a study of in vitro accuracy and stability of Neurovent-PTO and Licox sensors. Acta Neurochir (Wien). 2010;152(4):681-8.
30. Purins K, Sedigh A, Molnar C, et al. Standardized experimental brain death model for studies of intracranial dynamics, organ preservation, and organ transplantation in the pig. Crit Care Med. 2011;39(3):512-7.
31. Marklund N, Blennow K, Zetterberg H, Ronne-Engstrom E, Enblad P, Hillered L. Monitoring of brain interstitial total tau and beta amyloid proteins by microdialysis in patients with traumatic brain injury. J Neurosurg. 2009;110(6):1227-37.
32. Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30(1):119-41. (Pubitemid 34112188)
33. Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000;342(20):1471-7. (Pubitemid 30318270)
34. Schweickert WD, Gehlbach BK, Pohlman AS, Hall JB, Kress JP. Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients. Crit Care Med. 2004;32(6):1272-6. (Pubitemid 38738578)
35. Wittbrodt ET. Daily interruption of continuous sedation. Pharmacotherapy. 2005;25(5 Pt 2):3S-7S. (Pubitemid 40604873)
36. Anifantaki S, Prinianakis G, Vitsaksaki E, et al. Daily interruption of sedative infusions in an adult medical-surgical intensive care unit: randomized controlled trial. J Adv Nurs. 2009;65(5):1054-60.
37. Augustes R, Ho KM. Meta-analysis of randomised controlled trials on daily sedation interruption for critically ill adult patients. Anaesth Intensive Care. 2011;39(3):401-9.
38. Bucknall TK, Manias E, Presneill JJ. A randomized trial of protocol-directed sedation management for mechanical ventilation in an Australian intensive care unit. Crit Care Med. 2008;36(5):1444-50. (Pubitemid 351620640)
39. Mehta S, Burry L, Cook D, et al. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. JAMA. 2012;308(19):1985-92.
40. Stover JF. Arousal from sedation in wake-up tests requires careful risk stratification. Crit Care Med. 2012;40(1):338-40.
41. Enblad P, Frykholm P, Valtysson J, et al. Middle cerebral artery occlusion and reperfusion in primates monitored by microdialysis and sequential positron emission tomography. Stroke. 2001;32(7):1574-80. (Pubitemid 32631908)
42. Kett-White R, Hutchinson PJ, Al-Rawi PG, et al. Extracellular lactate/pyruvate and glutamate changes in patients during peroperative episodes of cerebral ischaemia. Acta Neurochir Suppl. 2002;81:363-5.
43. Persson L, Valtysson J, Enblad P, et al. Neurochemical monitoring using intracerebral microdialysis in patients with subarachnoid hemorrhage. J Neurosurg. 1996;84(4):606-16. (Pubitemid 26104228)
44. Frykholm P, Hillered L, Langstrom B, Persson L, Valtysson J, Enblad P. Relationship between cerebral blood flow and oxygen metabolism, and extracellular glucose and lactate concentrations during middle cerebral artery occlusion and reperfusion: a microdialysis and positron emission tomography study in nonhuman primates. J Neurosurg. 2005;102(6):1076-84. (Pubitemid 43193977)
45. Persson L, Hillered L. Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis. J Neurosurg. 1992;76(1):72-80.
46. Engstrom M, Polito A, Reinstrup P, et al. Intracerebral microdialysis in severe brain trauma: the importance of catheter location. J Neurosurg. 2005;102(3):460-9. (Pubitemid 43194037)
47. Koizumi H, Fujisawa H, Nomura S, et al. Dual microdialysis probe monitoring for patients with traumatic brain injury. Acta Neurochir Suppl. 2008;102:193-6.
48. Nelson DW, Thornquist B, MacCallum RM, et al. Analyses of cerebral microdialysis in patients with traumatic brain injury: relations to intracranial pressure, cerebral perfusion pressure and catheter placement. BMC Med. 2011;9:21.
49. Timofeev I, Czosnyka M, Carpenter KL, et al. Interaction between brain chemistry and physiology after traumatic brain injury: impact of autoregulation and microdialysis catheter location. J Neurotrauma. 2011;28(6):849-60.
50. Vespa PM, O'Phelan K, McArthur D, et al. Pericontusional brain tissue exhibits persistent elevation of lactate/pyruvate ratio independent of cerebral perfusion pressure. Crit Care Med. 2007;35(4):1153-60. (Pubitemid 46598968)
51. Clausen F, Marklund N, Lewen A, Enblad P, Basu S, Hillered L. Interstitial F(2)-isoprostane 8-iso-PGF(2alpha) as a biomarker of oxidative stress after severe human traumatic brain injury. J Neurotrauma. 2012;29(5):766-75.
52. Lewen A, Hillered L. Involvement of reactive oxygen species in membrane phospholipid breakdown and energy perturbation after traumatic brain injury in the rat. J Neurotrauma. 1998;15(7):521-30. (Pubitemid 28313410)
53. Stiefel MF, Udoetuk JD. Spiotta A.M et al. Conventional neurocritical care and cerebral oxygenation after traumatic brain injury. J Neurosurg. 2006;105:568-75. (Pubitemid 44525888)
54. van den Brink WA. van SH, Steyerberg EW et al. Brain oxygen tension in severe head injury. Neurosurgery. 2000;46(4):868-76.
55. Haitsma IK, Maas AI. Monitoring cerebral oxygenation in traumatic brain injury. Prog Brain Res. 2007;161:207-16. (Pubitemid 47017405)
56. Hlatky R, Valadka AB, Goodman JC, Contant CF, Robertson CS. Patterns of energy substrates during ischemia measured in the brain by microdialysis. J Neurotrauma. 2004;21(7):894-906. (Pubitemid 38998917)
57. Meixensberger J, Kunze E, Barcsay E, Vaeth A, Roosen K. Clinical cerebral microdialysis: brain metabolism and brain tissue oxygenation after acute brain injury. Neurol Res. 2001;23(8):801-6. (Pubitemid 33096898)
58. Meixensberger J, Jaeger M, Vath A, Dings J, Kunze E, Roosen K. Brain tissue oxygen guided treatment supplementing ICP/CPP therapy after traumatic brain injury. J Neurol Neurosurg Psychiatry. 2003;74(6):760-4. (Pubitemid 36628290)
59. Purins K, Enblad P, Wiklund L, Lewen A. Brain tissue oxygenation and cerebral perfusion pressure thresholds of ischemia in a standardized pig brain death model. Neurocrit Care. 2012;16(3):462-9.
60. Chieregato A, Calzolari F, Trasforini G, Targa L, Latronico N. Normal jugular bulb oxygen saturation. J Neurol Neurosurg Psychiatry. 2003;74(6):784-6. (Pubitemid 36628294)
61. Robertson CS, Narayan RK, Gokaslan ZL, et al. Cerebral arteriovenous oxygen difference as an estimate of cerebral blood flow in comatose patients. J Neurosurg. 1989;70:222-30. (Pubitemid 19051719)
62. Robertson C. Desaturation episodes after severe head injury: influence on outcome. Acta Neurochir Suppl (Wien). 1993;59:98-101.
63. Gallagher CN, Carpenter KL, Grice P, et al. The human brain utilizes lactate via the tricarboxylic acid cycle: a 13C-labelled microdialysis and high-resolution nuclear magnetic resonance study. Brain. 2009;132(Pt 10):2839-49.
64. Glenn TC, Kelly DF, Boscardin WJ, et al. Energy dysfunction as a predictor of outcome after moderate or severe head injury: indices of oxygen, glucose, and lactate metabolism. J Cereb Blood Flow Metab. 2003;23(10):1239-50. (Pubitemid 37229527)
65. Perez A, Minces PG, Schnitzler EJ, Agosta GE, Medina SA, Ciraolo CA. Jugular venous oxygen saturation or arteriovenous difference of lactate content and outcome in children with severe traumatic brain injury. Pediatr Crit Care Med. 2003;4(1):33-8.
66. Poca MA, Sahuquillo J, Vilalta A, Garnacho A. Lack of utility of arteriojugular venous differences of lactate as a reliable indicator of increased brain anaerobic metabolism in traumatic brain injury. J Neurosurg. 2007;106(4):530-7. (Pubitemid 46536447)
67. Schulz MK, Wang LP, Tange M, Bjerre P. Cerebral microdialysis monitoring: determination of normal and ischemic cerebral metabolisms in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg. 2000;93(5):808-14. (Pubitemid 32803404)
68. Prisco L, Citerio G. To wake-up, or not to wake-up: that is the Hamletic neurocritical care question! Crit Care. 2012;16(6):190.
69. Meierhans R, Brandi G, Fasshauer M, et al. Arterial lactate above 2 mM is associated with increased brain lactate and decreased brain glucose in patients with severe traumatic brain injury. Minerva Anestesiol. 2012;78(2):185-93.
70. Reinstrup P, Stahl N, Mellergard P, Uski T, Ungerstedt U, Nordstrom CH. Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery. Neurosurgery. 2000;47(3):701-9.