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Ischemia Modified Albumin in Traumatic Brain Injury

2018-08-22 20:45:16 | BioPortfolio

Summary

In the current study the investigators intend to evaluate the role of Ischemia modified albumin (IMA) in the prediction of poor outcome in patients with traumatic brain injury (TBI). The investigators hypothesize that IMA will be elevated in patients with traumatic brain injury due to the excessive production of reactive oxygen species by the injured brain.

Description

Consecutive adult patients who will be admitted with TBI, blood samples will be taken once written informed consent obtained. Initial evaluation on admission will be performed simultaneously by ICU physician and a neurosurgical resident by means of a detailed physical and neurological examination. Demographic characteristics and vascular risk factors (hypertension, diabetes mellitus, hyperlipidemia, and peripheral ischemic disease) will be recorded in details. Also, Routine blood tests, including full blood count, coagulation tests, glucose level, renal and hepatic function tests, total protein, and albumin levels; chest radiography will be done.

CT scan will be performed in all the cases for the confirmation of TBI. Glasgow coma scale (GCS) will be assessed on admission and recorded and assessed daily to evaluate prognosis. Patients will be monitored by BP, ECG, and Pulse oximetry. All patients will receive standard medical treatment which include anti-edema measures mannitol 20%, 0.25-0.5 g/kg over 20 min, (not exceeding a total of 2 g/kg of body weight in 24 h) in patients with symptoms of raised intracranial pressure, and other supportive therapy for the treatment of concurrent illnesses such as hypertension and diabetes mellitus.

Biochemical Assessments:

Blood samples will be placed in plain tubes containing separation gels and allowed to clot for 30 min. They will be centrifuged before separating the serum. Samples will immediately frozen and stored at -80°C for the IMA.

IMA will be measured using ELISA technique. Data collection

- Patients' characteristics: age, gender, BMI, cause of ICU admission.

- IMA will be measured at time of admission to ICU and 24h later

- Other data collections:

- Hear rate (HR), systolic blood pressure,central venous pressure (CVP), body temperature. All hemodynamic parameters will be measured and will be recorded at time of admission and every 2 hours for 24 hours

- Length of ICU stay

- 28-day mortality

- Troponin I level on admission and 24 hours after admission

- GCS at admission and daily till mortality or discharge

Study Design

Conditions

Traumatic Brain Injury

Intervention

Ischemia modified albumin (IMA)

Location

Kasr El Aini Hospital
Cairo
Egypt
11562

Status

Recruiting

Source

Kasr El Aini Hospital

Results (where available)

View Results

Links

Published on BioPortfolio: 2018-08-22T20:45:16-0400

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Medical and Biotech [MESH] Definitions

Prolonged unconsciousness from which the individual cannot be aroused, associated with traumatic injuries to the BRAIN. This may be defined as unconsciousness persisting for 6 hours or longer. Coma results from injury to both cerebral hemispheres or the RETICULAR FORMATION of the BRAIN STEM. Contributing mechanisms include DIFFUSE AXONAL INJURY and BRAIN EDEMA. (From J Neurotrauma 1997 Oct;14(10):699-713)

Constriction of arteries in the SKULL due to sudden, sharp, and often persistent smooth muscle contraction in blood vessels. Intracranial vasospasm results in reduced vessel lumen caliber, restricted blood flow to the brain, and BRAIN ISCHEMIA that may lead to hypoxic-ischemic brain injury (HYPOXIA-ISCHEMIA, BRAIN).

Softening or loss of brain tissue following CEREBRAL INFARCTION; cerebral ischemia (see BRAIN ISCHEMIA), infection, CRANIOCEREBRAL TRAUMA, or other injury. The term is often used during gross pathologic inspection to describe blurred cortical margins and decreased consistency of brain tissue following infarction. Multicystic encephalomalacia refers to the formation of multiple cystic cavities of various sizes in the cerebral cortex of neonates and infants following injury, most notably perinatal hypoxia-ischemic events. (From Davis et al., Textbook of Neuropathology, 2nd ed, p665; J Neuropathol Exp Neurol, 1995 Mar;54(2):268-75)

A form of acquired brain injury which occurs when a sudden trauma causes damage to the brain.

Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.

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