Fenger Anne-Sophie Worm, Lund Anton, Vassilieva Alexandra, Andreasen Trine Hjorslev, Ebdrup Søren Røddik, Bodilsen Tobias Sjørslev, Jensen Helene Ravnholt, Olsen Markus Harboe, Møller Kirsten
Copenhagen Neurointensive Care Research Association (CONICA), Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Department of Neurosurgery, The Neuroscience Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2025 Jul;69(6):e70078. doi: 10.1111/aas.70078.
Markers of cerebral metabolism measured by microdialysis (CMD) may warn clinicians of impending neuroworsening in patients with severe acute brain injury. This retrospective study investigated the relationship between systemic glucose levels and microdialysate glucose (CMD-glucose) in patients with severe traumatic brain injury (TBI) or aneurysmal subarachnoid haemorrhage (SAH).
We retrospectively investigated patients who underwent CMD. Linear regression and correlation analysis between temporally matched values of systemic and CMD-glucose were performed. Disease severity was dichotomized using the Glasgow Coma Scale score (GCS) at admission, and patient outcome at 6 months was dichotomized using the modified Rankin Scale.
Data was available from 133 patients, of which 75 had SAH and 58 had TBI. The R suggested that systemic glucose levels explained 31% (95% CI: 14-39) of CMD-glucose variation in SAH patients and 15% (95% CI: 5-45) in TBI patients. In a linear regression model, CMD-glucose increased by 0.16 (95% CI: 0.16-0.17) for patients with SAH and 0.17 (95% CI: 0.16-0.18) mmol/L for patients with TBI for every 1 mmol/L increase in systemic glucose. Furthermore, both systemic and CMD-glucose decreased with increasing time from ictus. We found no association between CMD-glucose and disease severity or functional outcome.
In this retrospective analysis of patients with severe acute brain injury undergoing intracerebral microdialysis, changes in systemic glucose contributed to changes in CMD-glucose with no relation to functional outcome.
This study assessed microdialysis-derived brain tissue extracellular glucose levels, analysed together with serum glucose levels measured at the same time; this was in patients with acute brain injury with sampling in the less injured cerebral hemisphere. Findings demonstrated that there were predictable changes in microdialysate glucose levels when serum glucose levels changed. Neither of these glucose levels was associated with functional outcomes.
Clinicaltrials.gov identifier: NCT06302244.
通过微透析测量的脑代谢标志物（CMD）可能会提醒临床医生注意重症急性脑损伤患者即将出现的神经功能恶化。这项回顾性研究调查了重度创伤性脑损伤（TBI）或动脉瘤性蛛网膜下腔出血（SAH）患者的全身血糖水平与微透析葡萄糖（CMD-葡萄糖）之间的关系。
我们回顾性研究了接受CMD的患者。对全身血糖和CMD-葡萄糖的时间匹配值进行线性回归和相关性分析。使用入院时的格拉斯哥昏迷量表评分（GCS）将疾病严重程度分为两类，使用改良Rankin量表将6个月时的患者预后分为两类。
共有133例患者的数据，其中75例为SAH，58例为TBI。R值表明，全身血糖水平解释了SAH患者中CMD-葡萄糖变化的31%（95%CI：14-39）和TBI患者中15%（95%CI：5-45）。在一个线性回归模型中，全身血糖每升高1 mmol/L，SAH患者的CMD-葡萄糖升高0.16（95%CI：0.16-0.17），TBI患者的CMD-葡萄糖升高0.17（95%CI：0.16-0.18）mmol/L。此外，全身血糖和CMD-葡萄糖均随着发病时间的增加而降低。我们发现CMD-葡萄糖与疾病严重程度或功能预后之间没有关联。
在这项对接受脑内微透析的重症急性脑损伤患者的回顾性分析中，全身血糖的变化导致了CMD-葡萄糖的变化，且与功能预后无关。
本研究评估了微透析衍生的脑组织细胞外葡萄糖水平，并与同时测量的血清葡萄糖水平一起进行分析；研究对象为急性脑损伤患者，在损伤较轻的脑半球进行采样。研究结果表明，当血清葡萄糖水平变化时，微透析葡萄糖水平存在可预测的变化。这两种葡萄糖水平均与功能预后无关。
Clinicaltrials.gov标识符：NCT06302244。
