Extracellular fluid S100B in the injured brain: a future surrogate marker of acute brain injury?

2005 ◽  
Vol 147 (8) ◽  
pp. 897-900 ◽  
Author(s):  
J. Sen ◽  
A. Belli ◽  
A. Petzold ◽  
S. Russo ◽  
G. Keir ◽  
...  
Keyword(s):  
Brain Injury ◽  
Surrogate Marker ◽  
Extracellular Fluid ◽  
Acute Brain Injury ◽  
Injured Brain

scholarly journals Metronidazole and Hydroxymetronidazole Central Nervous System Distribution: 1. Microdialysis Assessment of Brain Extracellular Fluid Concentrations in Patients with Acute Brain Injury

2013 ◽  
Vol 58 (2) ◽  
pp. 1019-1023 ◽  
Author(s):  
Denis Frasca ◽  
Claire Dahyot-Fizelier ◽  
Christophe Adier ◽  
Olivier Mimoz ◽  
Bertrand Debaene ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Steady State ◽  
Brain Injury ◽  
Plasma Concentration ◽  
Extracellular Fluid ◽  
Acute Brain Injury ◽  
Cerebral Microdialysis ◽  
Pharmacokinetic Analysis ◽  
Concentration Time

ABSTRACTThe distribution of metronidazole in the central nervous system has only been described based on cerebrospinal fluid data. However, extracellular fluid (ECF) concentrations may better predict its antimicrobial effect and/or side effects. We sought to explore by microdialysis brain ECF metronidazole distribution in patients with acute brain injury. Four brain-injured patients monitored by cerebral microdialysis received 500 mg of metronidazole over 0.5 h every 8 h. Brain dialysates and blood samples were collected at steady state over 8 h. Probe recoveries were evaluated byin vivoretrodialysis in each patient for metronidazole. Metronidazole and OH-metronidazole were assayed by high-pressure liquid chromatography, and a noncompartmental pharmacokinetic analysis was performed. Probe recovery was equal to 78.8% ± 1.3% for metronidazole in patients. Unbound brain metronidazole concentration-time curves were delayed compared to unbound plasma concentration-time curves but with a mean metronidazole unbound brain/plasma AUC0–τratio equal to 102% ± 19% (ranging from 87 to 124%). The unbound plasma concentration-time profiles for OH-metronidazole were flat, with mean average steady-state concentrations equal to 4.0 ± 0.7 μg ml−1. This microdialysis study describes the steady-state brain distribution of metronidazole in patients and confirms its extensive distribution.

scholarly journals Brain Microdialysis Study of Meropenem in Two Patients with Acute Brain Injury

2010 ◽  
Vol 54 (8) ◽  
pp. 3502-3504 ◽  
Author(s):  
Claire Dahyot-Fizelier ◽  
Ivan Timofeev ◽  
Sandrine Marchand ◽  
Peter Hutchinson ◽  
Bertrand Debaene ◽  
...  
Keyword(s):  
Experimental Data ◽  
Brain Injury ◽  
Pharmacokinetic Model ◽  
Extracellular Fluid ◽  
Acute Brain Injury ◽  
Brain Microdialysis ◽  
Time Curve ◽  
Concentration Time ◽  
Microdialysis Study

ABSTRACT Concentrations of unbound meropenem in the cerebral extracellular fluid (ECF) of two patients with acute brain injury were assessed by microdialysis. Brain ECF unbound-meropenem concentrations were lower than serum unbound-meropenem concentrations, with brain-to-serum area under the concentration-time curve ratios of 0.73 and 0.14. A pharmacokinetic model was developed to fit the experimental data adequately.

scholarly journals Microdialysis Study of Cefotaxime Cerebral Distribution in Patients with Acute Brain Injury

2013 ◽  
Vol 57 (6) ◽  
pp. 2738-2742 ◽  
Author(s):  
Claire Dahyot-Fizelier ◽  
Denis Frasca ◽  
Nicolas Grégoire ◽  
Christophe Adier ◽  
Olivier Mimoz ◽  
...  
Keyword(s):  
Brain Injury ◽  
High Performance ◽  
Plasma Concentrations ◽  
Extracellular Fluid ◽  
Area Under The Curve ◽  
Acute Brain Injury ◽  
Brain Distribution ◽  
Content Type ◽  
Dosing Regimens

ABSTRACTCentral nervous system (CNS) antibiotic distribution was described mainly from cerebrospinal fluid data, and only few data exist on brain extracellular fluid concentrations. The aim of this study was to describe brain distribution of cefotaxime (2 g/8 h) by microdialysis in patients with acute brain injury who were treated for a lung infection. Microdialysis probes were inserted into healthy brain tissue of five critical care patients. Plasma and unbound brain concentrations were determined at steady state by high-performance liquid chromatography.In vivorecoveries were determined individually using retrodialysis by drug. Noncompartmental and compartmental pharmacokinetic analyses were performed. Unbound cefotaxime brain concentrations were much lower than corresponding plasma concentrations, with a mean cefotaxime unbound brain-to-plasma area under the curve ratio equal to 26.1 ± 12.1%. This result was in accordance with the brain input-to-brain output clearances ratio (CLin,brain/CLout,brain). Unbound brain concentrations were then simulated at two dosing regimens (4 g every 6 h or 8 h), and the time over the MICs (T>MIC) was estimated for breakpoints of susceptible and resistantStreptococcus pneumoniaestrains. T>MIC was higher than 90% of the dosing interval for both dosing regimens for susceptible strains and only for 4 g every 6 h for resistant ones. In conclusion, brain distribution of cefotaxime was well described by microdialysis in patients and was limited.

scholarly journals Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury

2017 ◽  
Vol 06 (02) ◽  
pp. 086-094
Author(s):  
Deepak Gupta ◽  
Anna Mazzeo
Keyword(s):  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Rescue Therapy ◽  
Standard Of Care ◽  
Acute Brain Injury ◽  
Cerebral Microdialysis ◽  
Therapeutic Window ◽  
Biochemical Alterations ◽  
Injured Brain ◽  
Severe Tbi

AbstractPatients with traumatic brain injury (TBI) have variable outcomes subject to intracranial hypertension, ischemia, hypotension, and various biochemical alterations. Multimodality neurointensive monitoring is standard of care for decision making in all severe TBI cases at present in most neurotrauma units. Neuromonitoring tools, such as cerebral microdialysis, may contribute to understanding the pathomechanisms of acute brain injury, provide an early warning of secondary cerebral deterioration (therapeutic window of opportunity), and help in selecting the patients most suitable to benefit from this very invasive surgical rescue therapy. Cerebral microdialysis can be used as a measure of the effect of decompressive craniectomy on neurochemistry derangement and brain energy crisis jeopardizing the injured brain. Present review discusses the cerebral microdialysis, its usefulness, and role in prognostication of severe TBIs, especially in patients post-decompressive craniectomy. The authors also discuss the current consensus guidelines on usage of cerebral microdialysis in TBI patients.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

A methodology for detecting and exploring non-convulsive seizures in patients with acute brain injury

2014 ◽  
Vol 2 ◽  
pp. 396-399 ◽  
Author(s):  
DJ Albers ◽  
J Claassen ◽  
M Schmidt ◽  
G Hripcsak
Keyword(s):  
Brain Injury ◽  
Acute Brain Injury ◽  
Convulsive Seizures

Alterations of blood IL-8, TGF-beta1 and nitric oxide levels in relation to blood cells in patients with acute brain injury

Therapy ◽  
2006 ◽  
Vol 3 (3) ◽  
pp. 399-405
Author(s):  
Elham Hadidi ◽  
Mojtaba Mojtahedzadeh ◽  
Mohammad Hassan Paknejad ◽  
Shekoufeh Nikfar ◽  
Mohammad Jafar Zamani ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Brain Injury ◽  
Blood Cells ◽  
Acute Brain Injury

Heart rate and blood pressure variability and baroreflex sensitivity in patients with acute brain injury

2005 ◽  
Vol 20 (4) ◽  
pp. 394 ◽  
Author(s):  
V. Papaioannou ◽  
M. Giannakou ◽  
N. Maglaveras ◽  
E. Sofianos ◽  
M. Giala
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Brain Injury ◽  
Blood Pressure Variability ◽  
Baroreflex Sensitivity ◽  
Acute Brain Injury
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