tailieunhanh - Báo cáo y học: "Optimizing cerebral glucose in severe traumatic brain injury: still some way to go"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Optimizing cerebral glucose in severe traumatic brain injury: still some way to go. | Available online http content 13 2 131 Commentary Optimizing cerebral glucose in severe traumatic brain injury still some way to go Cameron Zahed and Arun K Gupta Addenbrooke s Hospital Cambridge University Hospitals NHS Foundation Trust Hills Road Cambridge CB2 2QQ UK Corresponding author Arun K Gupta akg01@ See related research by Holbein et al. http content 13 1 R13 Published 6 April 2009 This article is online at http content 13 2 131 2009 BioMed Central Ltd Critical Care 2009 13 131 doi cc7753 Abstract This commentary considers some of the factors that affect cerebral glucose metabolism in patients with traumatic brain injury. A study recently reported in Critical Care suggested a blood glucose range that may optimize cerebral glucose utilization the findings of this study are evaluated and discussed. Some of the mechanisms of cerebral glucose control are explored including the impact of intensive insulin therapy on cerebral metabolism. Although glycaemic control in intensive care patients has been fertile ground for research over many years optimizing cerebral glucose in acute brain injury has more recently attracted the interest of physicians involved in neurocritical care. The key research themes that are emerging include determining the range of arterial blood glucose that optimizes brain glucose concentration the threshold of extracellular glucose below which neuronal injury occurs determining the pathophysiological changes in the brain caused by deranged glucose control and elucidating the effects of insulin therapy on cerebral glucose metabolism. Holbein and coworkers 1 have begun to address some of these questions by using arterial and jugular venous measurements to determine a range of plasma glucose between which cerebral metabolism is optimized in patients with traumatic brain injury TBI . Their findings albeit from retrospective data suggest an optimal arterial blood glucose level of 6 to 8