title: Intrathecal and systemic concentration of NT-proBNP in patients with severe traumatic brain injury.
abstract: Outcome of patients suffering from traumatic brain injury (TBI) depends on the development of secondary brain damage. In this context, recent studies underlined the role of the natriuretic peptides- atrial natriuretic peptide and brain natriuretic peptide (BNP)-in aneurysmatic subarachnoidal hemorrhage (SAH). Especially BNP correlates with intracranial pressure and clinical outcome after SAH. Since its role in TBI remains unclear, the intracranial and systemic concentrations of N-terminal (NT)-proBNP were analyzed in patients suffering from severe TBI. We measured NT-proBNP levels in cerebrospinal fluid (CSF) and serum of 14 patients suffering from severe TBI (GCS<or=8 points) and 10 healthy control patients, using proBNP assay (Roche Diagnostics). Samples were collected after placement of a ventricular catheter, and at 12, 24, 48, and 72 h after TBI. CSF/serum albumin ratio (Q<a) was daily calculated. At 90 days after TBI, outcome was evaluated using the Glasgow Outcome Scale (GOS). In patients exhibiting a mean ICP of >15 mm Hg (n=6), the serum (800+/-150 pg/mL) and CSF levels (55+/-9 pg/mL) of NT-proBNP were significantly increased after 24 h, as compared to patients with ICP<or=15 mm of Hg (n=8) as well as to control group. However, Qa as well as GOS did not significantly differ among both groups. For the first time, we evaluated intrathecal and systemic NT-proBNP concentrations in patients suffering from severe TBI. Interestingly, NT-proBNP in CSF and serum was significantly elevated in patients exhibiting an ICP of >15 mm Hg. Further studies are currently performed to elucidate the physiologic role of NT-proBNP in TBI.
authors.affiliation: Chirurgische Klinik und Poliklinik, Klinikum Innenstadt, Ludwig-Maximilians-Universitaet, Munich, Germany. Chlodwig.Kirchhoff@med.uni-muenchen.de
authors.forename: Chlodwig
authors.initials: C
authors.lastname: Kirchhoff
authors.forename: Julia
authors.initials: J
authors.lastname: Stegmaier
authors.forename: Viktoria
authors.initials: V
authors.lastname: Bogner
authors.forename: Sonja
authors.initials: S
authors.lastname: Buhmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Mussack
authors.forename: Uwe
authors.initials: U
authors.lastname: Kreimeier
authors.forename: Wolf
authors.initials: W
authors.lastname: Mutschler
authors.forename: Peter
authors.initials: P
authors.lastname: Biberthaler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001812:Blood-Brain Barrier / Q000502:physiology; D001930:Brain Injuries / Q000134:cerebrospinal fluid / Q000378:metabolism*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000134:cerebrospinal fluid / Q000378:metabolism*; D010446:Peptide Fragments / Q000134:cerebrospinal fluid / Q000378:metabolism*; D010865:Pilot Projects; D014057:Tomography, X-Ray Computed
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain