Determinants of cerebral extracellular potassium after severe human head injury.
Determinants of cerebral extracellular potassium after severe human head injury.
复制标题
严重人脑损伤后脑细胞外钾的决定因素。
DOI：
10.1007/978-3-7091-6415-0_7
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Bullock,R
中科院分区：
文献类型：
--
作者：
Doppenberg,EM;Reinert,M;Zauner,A;Massie,TS;Bullock,R
The key role players of brain swelling seen after severe human head injury have only been partly determined. We used our human head injury data base to determine relationships between potassium, glutamate, lactate and cerebral blood flow (CBF). A total of 70 severely head injured patients (GCS ≤ 8) were studied using intracerebral microdialysis to measure extracellular glutamate, potassium and lactate. Xenon CT was used to determine regional cerebral blood flow (rCBF).The mean ± SEM of the r value of all patients, between potassium and glutamate, and potassium and lactate was 0.25 ± 0.04 (p < 0.0001) and 0.17 ± 0.06 (p = 0.006). respectively. demonstrating in both cases a positive relationship. rCBF was negatively correlated with potassium with marginal significance (r = -0.35. p = 0.08). When separated into two groups. patients with contusion had higher potassium levels than patients without contusion (1.55 ± 0.03 mmolll versus 1.26 ± 0.02 mmollI. respectively). These results in severely head injured patients confirm previous in vitro and animal studies in which relationships between potassium. glutamate. lactate and CBF were found. Potassium efflux is a major determinant of cell swelling leading to clinically significant cytotoxic edema due to increased glutamate release during reduced cerebral blood flow.
