• Eur Rev Med Pharmaco · Feb 2013

    Randomized Controlled Trial

    Reliability of calcium-binding protein S100B measurement toward optimization of hyperosmolal therapy in traumatic brain injury.

    • N Hendoui, M T Beigmohammadi, A Mahmoodpoor, A Ahmadi, M Abdollahi, M Hasanpour, F Hadi, Z Khazaeipour, S Mousavi, and M Mojtahedzadeh.
    • Department of Pharmacotherapy, Faculty of Pharmacy, Mazandaran University of Medical Science and Health Services, Sari, Iran.
    • Eur Rev Med Pharmaco. 2013 Feb 1;17(4):477-85.

    BackgroundOsmotherapy is a cornerstone for the management of severe Traumatic Brain Injury (TBI). Hypertonic saline (HTS) has advantages as being preferred osmotic agent, but there is inadequte knowledge regarding dose and its saftey in comparison to mannitol. S100B, as a specific neuroinflammatory biomarker in TBI might be a reliable therapeutic index following osmotic therapy.AimTo compare both administration ways of HTS 5% (bolus and infusion) with mannitol upon S100B as a therapeutic tool for monitoring treatment in TBI patients.MethodAdult patients wih modrate to severe TBI were recruited and have randomly received one of the three protocols: 125 cc of HTS 5% every 6 hrs (N: 11) as bolus; 500 cc of HTS 5% (N: 12) as infusion for 24 hrs; or 1 g/kg mannitol of 20% (N: 10) as a bolus, repeated with a dose of 0.25-0.5 g/kg every 6 hrs based on patient's response for 3 days. Serum S100B, blood pressure, serum sodium and osmolality and Glascow coma score (GCS) were measured at baseline and daily for 3 days.ResultsInitial serum S100B level in TBI patients was higher than control group (p < 0.0001). Levels of measured S100B have decreased for all treatment groups, but reduction wasn't significantly after hyperosmolal therapy. GCS level increased significantly in infusion group (p = 0.002) and there were negative and significant correlation between serum S100B level and GCS level in some days. Mean arterial pressure increased significantly in HTS groups (bolus: p = 0.002, infusion < 0.0001).ConclusionsS100B is closely related to the pathophysiological mechanism in TBI and may be useful as a therapeutic tool for treatment monitoring in TBI patients HTS is a safe and effective osmotic agent in TBI setting.  

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?

    User can't be blank.

    Content can't be blank.

    Content is too short (minimum is 15 characters).

    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…