Optimizing cerebral glucose in severe traumatic brain injury still some way to go 英文参考文献.docVIP

Available online /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@globalnet.co.uk See related research by Holbein et al., /content/13/1/R13 Published: 6 April 2009 Critical Care 2009, 13:131 (doi:10.1186/cc7753) This article is online at /content/13/2/131 ? 2009 BioMed Central Ltd Abstract is related to poor outcome after TBI, suggest that plasma glucose concentration may not be a good reflection of extracellular cerebral glucose concentrations [3,4]. This is supported by Schlenk and coworkers [5], who found that cerebral glucose levels varied independently of plasma glucose in patients with subarachnoid haemorrhage. This clearly makes control of cerebral glucose based on plasma glucose much more difficult to achieve, particularly when 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. significant metabolic heterogeneity exists after TBI, as 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 tha