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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.
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.
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
Traumatic Brain Injury
Ischemia modified albumin (IMA)
Kasr El Aini Hospital
Kasr El Aini Hospital
Published on BioPortfolio: 2018-08-22T20:45:16-0400
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