title: Increased blood glucose is related to disturbed cerebrovascular pressure reactivity after traumatic brain injury.
abstract: BACKGROUND
  Increased blood glucose and impaired pressure reactivity (PRx) after traumatic brain injury (TBI) are both known to correlate with unfavorable patient outcome. However, the relationship between these two variables is unknown.
  
  
  METHODS
  To test the hypothesis that increased blood glucose leads to increased PRx, we retrospectively analyzed data from 86 traumatic brain injured patients admitted to the Neurocritical Care Unit. Data analyzed included arterial glucose concentration, intracranial pressure (ICP), cerebral perfusion pressure (CPP) and end-tidal CO2. PRx was calculated as the moving correlation coefficient between averaged (10 seconds) arterial blood pressure and ICP. One arterial glucose concentration and one time-aligned PRx value were obtained for each patient, during each day until the fifth day after ictus.
  
  
  RESULTS
  Mean arterial glucose concentrations during the first 5 days since ictus were positively correlated with mean PRx (Pearson correlation coefficient = 0.25, p = 0.02). The correlation was strongest on the first day after injury (Pearson correlation coefficient = 0.47, p = 0.008).
  
  
  CONCLUSIONS
  Our preliminary findings indicate that increased blood glucose may impair cerebrovascular reactivity, potentially contributing to a mechanistic link between increased blood glucose and poorer outcome after TBI.
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Box 167, Cambridge, CB2 0QQ, UK, jd634@cam.ac.uk.
authors.forename: Joseph
authors.initials: J
authors.lastname: Donnelly
authors.forename: Marek
authors.initials: M
authors.lastname: Czosnyka
authors.forename: Nazneen
authors.initials: N
authors.lastname: Sudhan
authors.forename: Georgios V
authors.initials: GV
authors.lastname: Varsos
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nasr
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Jalloh
authors.forename: Xiuyun
authors.initials: X
authors.lastname: Liu
authors.forename: Celeste
authors.initials: C
authors.lastname: Dias
authors.forename: Mypinder S
authors.initials: MS
authors.lastname: Sekhon
authors.forename: Keri L H
authors.initials: KL
authors.lastname: Carpenter
authors.forename: David K
authors.initials: DK
authors.lastname: Menon
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hutchinson
authors.forename: Peter
authors.initials: P
authors.lastname: Smielewski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology*; D001930:Brain Injuries / Q000378:metabolism / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001786:Blood Glucose