title: Outcome of poor-grade subarachnoid hemorrhage as determined by biomarkers of glucose cerebral metabolism.
abstract: OBJECTIVE
  The aim of this study was to determine if the measurement of blood biomarkers of glucose cerebral metabolism, performed with retrograde jugular catheter, could predict the outcome of poor-grade aneurysmal subarachnoid hemorrhage (aSAH) patients.
  
  
  METHODS
  This study was conducted in 68 poor-grade aSAH patients. A total of 4,024 blood samples obtained from jugular and radial catheters were analyzed for glucose, lactate, and oxygen content every 8 h for 10 ± 0.5 days. Metabolic ratio (MR) and lactate-oxygen index (LOI) were obtained by ratios using arterio-jugular differences. Functional outcome was evaluated at 12 months with the Glasgow Outcome Scale.
  
  
  RESULTS
  Outcome was unfavorable in 40 patients. In this group of patients, the MR was significantly lower (p < 0.0001) and the LOI was significantly higher (p = 0.0001) than in the group with favorable outcome. The MR cutoff value, below which the patients are likely to have an unfavorable outcome, was determined to be 3.35. More interestingly, the data obtained in this study demonstrated that the patients achieving an unfavorable outcome were distinguished from those with a favorable outcome by having at least three events of MR inferior to 3.35 (sensitivity = 90 %, specificity = 82.1 %). Moreover, in patients who developed cerebral vasospasm, we observed a significant decrease in the MR.
  
  
  CONCLUSIONS
  Our data provide additional support to the view that the MR is a reliable marker for predicting the outcome of poor-grade aSAH patients. Prospective studies are needed to confirm its value in multimodal monitoring.
authors.affiliation: BioRaN Team, Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028, University Lyon 1, Lyon, France. gleicy.barcelos@hcuge.ch
authors.forename: Gleicy K
authors.initials: GK
authors.lastname: Barcelos
authors.forename: Yannick
authors.initials: Y
authors.lastname: Tholance
authors.forename: Sebastien
authors.initials: S
authors.lastname: Grousson
authors.forename: Bernard
authors.initials: B
authors.lastname: Renaud
authors.forename: Armand
authors.initials: A
authors.lastname: Perret-Liaudet
authors.forename: Frederic
authors.initials: F
authors.lastname: Dailler
authors.forename: Luc
authors.initials: L
authors.lastname: Zimmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001921:Brain / Q000378:metabolism*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications; D007601:Jugular Veins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017534:Radial Artery / Q000378:metabolism; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000378:metabolism* / Q000401:mortality; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose