Characterization of focal brain tissue water measurements in human traumatic brain injury

2019 
Abstract Background Cerebral edema is a major cause of morbidity in severe traumatic brain injury (TBI) patients. Intraparenchymal thermal conductivity-based probes that measure local cerebral blood flow (CBF) can measure percent brain tissue water (%BTW) content, but such measures have been insufficiently characterized in TBI patients. Methods We retrospectively reviewed physiologic data from severe TBI patients treated at our institution (2014–2016) who underwent CBF monitoring. Results Sixteen patients underwent focal %BTW measurements at a 15-minute sampling rate. %BTW measurements demonstrated characteristic temporal profiles with a mean time to peak of 3.7±1.7 days. The mean minimum and maximum %BTWs were 71.0±3.9% and 82.7±7.4%, respectively (overall mean %BTW 77.0±2.9%). Intracranial pressure (ICP) values of 22 mmHg—the current treatment threshold for trauma patients—corresponded to 75.8±5.4 %BTW. Repeated measures correlation showed %BTW is negatively correlated with serum sodium concentration (r=-0.3, p Conclusion %BTW may be a clinically useful, real-time measurement of cerebral edema in TBI patients. It is closely associated with the serum sodium concentration and follows a characteristic temporal course with characteristic trajectory and stability over time.
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