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Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi ve Vücut Sıcaklığının Prognoza Etkisi

Yıl 2022, Cilt: 48 Sayı: 2, 137 - 141, 15.09.2022
https://doi.org/10.32708/uutfd.1066850

Öz

Pediatrik kafa travması çocukluk çağının önemli mortalite ve morbidite sebepleri arasındadır. Acil servise başvuru anındaki parametrelere göre prognozun önceden bilinmesi tedavi ve yakın takip için uyarıcı olabilecektir. Bu çalışmada başvuru anındaki kan glukoz değerinin ve vücut sıcaklığının prognoz üzerine etkisinin Modifiye Rankin Skoru ile değerlendirilmesi planlanmıştır. Çalışmada Bursa Uludağ Üniversitesi Tıp Fakültesi Acil Servisi’ne başvuran 0-16 yaş aralığındaki 301 olgu incelenmiştir. Başvuru anındaki Glasgow Koma Skoru ile kan glukoz değeri arasında ters yönde korelasyon saptanmıştır. Ayrıca Glasgow Koma Skoru ile Modifiye Rankin Skoru arasında da ters yönde korelasyon gözlenirken, kan glukoz değeri ile Modifiye Rankin Skoru arasında pozitif yönde zayıf korelasyon saptanmıştır. Başvuru anında saptanan hiperterminin prognoz üzerine etkisinin olmadığı gözlenmiştir. Bu sonuçlar başvuru anındaki Glasgow Koma Skorunun yanı sıra kan glukoz değerinin yüksekliğinin prognoz tayininde önemli olabileceğini göstermiştir.

Kaynakça

  • 1. Scaife ER, Statler KD. Traumatic brain injury: Preferred methods and targets for resuscitation. Vol. 22, Current Opinion in Pediatrics. 2010. p. 339–45.
  • 2. Figaji AA. Anatomical and physiological differences between children and adults relevant to traumatic brain injury and the implications for clinical assessment and care. Vol. 8, Frontiers in Neurology. 2017.
  • 3. Sternbach GL. The Glasgow Coma Scale. J Emerg Med. 2000;19(1):67–71.
  • 4. Van de Voorde P, Turner NM, Djakow J, de Lucas N, Martinez-Mejias A, Biarent D, et al. European Resuscitation Council Guidelines 2021: Paediatric Life Support. Resuscitation. 2021;161:327–87.
  • 5. Bruno A, Biller J, Adams HP, Clarke WR, Woolson RF, Williams LS, et al. Acute blood glucose level and outcome from ischemic stroke. Neurology. 1999;52(2):280–4.
  • 6. Thompson HJ, Kirkness CJ, Mitchell PH. Intensive care unit management of fever following traumatic brain injury. Intensive Crit Care Nurs. 2007;23(2):91–6.
  • 7. Altun Ugras G, Yuksel S. Factors Affecting Intracranial Pressure and Nursing Interventions. J J Nurs Care. 2015;1(1):1–5.
  • 8. Farrell B, Godwin J, Richards S, Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: Final results. J Neurol Neurosurg Psychiatry. 1951;54(12):1044–54.
  • 9. Sadaka F, Patel D, Lakshmanan R. The FOUR score predicts outcome in patients after traumatic brain injury. Neurocrit Care. 2012;16(1):95–101.
  • 10. Love PF, Tepas JJ, Wludyka PS, Masnita-Iusan C. Fall-related pediatric brain injuries: The role of race, Age, and sex. In: Journal of Trauma - Injury, Infection and Critical Care. 2009.
  • 11. Işik HS, Gökyar A, Yildiz Ö, Bostanci U, Özdemir C. Pediatric head injuries, retrospective analysis of 851 patients: An epidemiological study. Ulus Travma ve Acil Cerrahi Derg. 2011 Mar 1;17(2):166–72.
  • 12. Şimşek O, Hiçdönmez T, Hamamcioǧlu MK, Kilinçer C, Parsak T, Tiryaki M, et al. Pediatric head injuries: A retrospective analysis of 280 patients. Ulus Travma ve Acil Cerrahi Derg. 2005;11(4):310–7.
  • 13. Verma S, Lal N, Lodha R, Murmu L. Childhood trauma profile at a tertiary care hospital in India. Indian Pediatr. 2009;46(2):168–71.
  • 14. Ökten Aİ, Yalman M, Kaptanoğlu E, Gül B, Gezici AR Sİ. Pediatrik kafa travmaları . Ulusal Travma Dergisi. 1996; 2:94–9.
  • 15. Liu-Deryke X, Collingridge DS, Orme J, Roller D, Zurasky J, Rhoney DH. Clinical impact of early hyperglycemia during acute phase of traumatic brain injury. Neurocrit Care 2009;11(2):151–7.
  • 16. Zhang Z, Yan J, Shi H. Role of Hypoxia Inducible Factor 1 in Hyperglycemia-Exacerbated Blood-Brain Barrier Disruption in Ischemic Stroke. Neurobiol Dis. 2016;95:82–92.
  • 17. Dietrich DW, Alonso O, Busto R. Moderate hyperglycemia worsens acute blood-brain barrier injury after forebrain ischemia in rats. Stroke. 1993;24(1):111–6.
  • 18. Li PA, He QP, Ouyang YB, Liu CL, Hu BR, Siesjö BK. Early release of cytochrome C and activation of caspase-3 in hyperglycemic rats subjected to transient forebrain ischemia. Brain Res. 2001;896(1–2):69–76.
  • 19. Widmer H, Abiko H, Faden AI, James TL, Weinstein PR. Effects of hyperglycemia on the time course of changes in energy metabolism and pH during global cerebral ischemia and reperfusion in rats: Correlation of 1H and 31P NMR spectroscopy with fatty acid and excitatory amino acid levels. J Cereb Blood Flow Metab. 1992;12(3):456–68.
  • 20. Folbergrova J, Memezawa H, Smith ML, Siesjo BK. Focal and perifocal changes in tissue energy state during middle cerebral artery occlusion in normo- and hyperglycemic rats. J Cereb Blood Flow Metab. 1992;12(1):25–33.
  • 21. Back T, Hoehn-Berlage M, Kohno K, Hossmann KA. Diffusion nuclear magnetic resonance imaging in experimental stroke correlation with cerebral metabolites. Stroke. 1994;25(2):494–500.
  • 22. Song EC, Chu K, Jeong SW, Jung KH, Kim SH, Kim M, et al. Hyperglycemia exacerbates brain edema and perihematomal cell death after intracerebral hemorrhage. Stroke. 2003;34(9):2215–20.
  • 23. Rao AK, Chouhan V, Chen X, Sun L, Boden G. Activation of the tissue factor pathway of blood coagulation during prolonged hyperglycemia in young healthy men. Diabetes. 1999;48(5):1156–61.
  • 24. Pandolfi A, Giaccari A, Cilli C, Alberta MM, Morviducci L, De Filippis EA, et al. Acute hyperglycemia and acute hyperinsulinemia decrease plasma fibrinolytic activity and increase plasminogen activator inhibitor type 1 in the rat. Acta Diabetol. 2001;38(2):71–6.
  • 25. Golden SH, Hill-Briggs F, Williams K, Stolka K, Mayer RS. Management of diabetes during acute stroke and inpatient stroke rehabilitation. Arch Phys Med Rehabil. 2005;86(12):2377–84.
  • 26. Shi J, Dong B, Mao Y, Guan W, Cao J, Zhu R, et al. Review: Traumatic brain injury and hyperglycemia, a potentially modifiable risk factor. Vol. 7, Oncotarget. 2016. p. 71052–61.
  • 27. Chong SL, Harjanto S, Testoni D, Ng ZM, Low CYD, Lee KP, et al. Early hyperglycemia in pediatric traumatic brain injury predicts for mortality, prolonged duration of mechanical ventilation, and intensive care stay. Int J Endocrinol. 2015;2015.
  • 28. Svedung Wettervik TM, Engquist H, Lenell S, Howells T, Hillered L, Rostami E, et al. Systemic Hyperthermia in Traumatic Brain Injury - Relation to Intracranial Pressure Dynamics, Cerebral Energy Metabolism, and Clinical Outcome. J Neurosurg Anesthesiol. 2021;33(4):329–36.
  • 29. Alkan T, Kahveci N, Buyukuysal L, Korfali E, Ozluk K. Neuroprotective effects of MK 801 and hypothermia used alone and in combination in hypoxic-ischemic brain injury in neonatal rats. Arch Physiol Biochem. 2001;109(2):135–44.
  • 30. Kahveci FS, Kahveci N, Alkan T, Goren B, Korfali E, Ozluk K. Propofol versus isoflurane anesthesia under hypothermic conditions: Effects on intracranial pressure and local cerebral blood flow after diffuse traumatic brain injury in the rat. Surg Neurol. 2001;56(3):206–14.

The Effect of Blood Glucose Level and Body Temperature on Prognosis in Pediatric Head Traumas

Yıl 2022, Cilt: 48 Sayı: 2, 137 - 141, 15.09.2022
https://doi.org/10.32708/uutfd.1066850

Öz

Pediatric head injuries is one of the most important etiological causes of mortality and morbidity in childhood. The early decision for the prognosis due to the parameters in the emergency department admission can be warning for treatment and close follow-up. The aim of this study is to evaluate the effect of blood glucose level and body temperature on prognosis at the time of admission by using the Modified Rankin Score. 301 cases between the ages of 0-16 who applied to the Bursa Uludağ University Faculty of Medicine Emergency Department were included in this study. A negative correlation was found between the Glasgow Coma Score and the blood glucose level. In addition, a negative correlation was observed between Glasgow Coma Score and Modified Rankin Score, while a weak positive correlation was found between blood glucose level and Modified Rankin Score. It was observed that the hyperthermia detected at the time of admission had no effect on the prognosis. These results showed that, the high blood glucose level may be important in determining the prognosis in addition to the Glasgow Coma Score.

Kaynakça

  • 1. Scaife ER, Statler KD. Traumatic brain injury: Preferred methods and targets for resuscitation. Vol. 22, Current Opinion in Pediatrics. 2010. p. 339–45.
  • 2. Figaji AA. Anatomical and physiological differences between children and adults relevant to traumatic brain injury and the implications for clinical assessment and care. Vol. 8, Frontiers in Neurology. 2017.
  • 3. Sternbach GL. The Glasgow Coma Scale. J Emerg Med. 2000;19(1):67–71.
  • 4. Van de Voorde P, Turner NM, Djakow J, de Lucas N, Martinez-Mejias A, Biarent D, et al. European Resuscitation Council Guidelines 2021: Paediatric Life Support. Resuscitation. 2021;161:327–87.
  • 5. Bruno A, Biller J, Adams HP, Clarke WR, Woolson RF, Williams LS, et al. Acute blood glucose level and outcome from ischemic stroke. Neurology. 1999;52(2):280–4.
  • 6. Thompson HJ, Kirkness CJ, Mitchell PH. Intensive care unit management of fever following traumatic brain injury. Intensive Crit Care Nurs. 2007;23(2):91–6.
  • 7. Altun Ugras G, Yuksel S. Factors Affecting Intracranial Pressure and Nursing Interventions. J J Nurs Care. 2015;1(1):1–5.
  • 8. Farrell B, Godwin J, Richards S, Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: Final results. J Neurol Neurosurg Psychiatry. 1951;54(12):1044–54.
  • 9. Sadaka F, Patel D, Lakshmanan R. The FOUR score predicts outcome in patients after traumatic brain injury. Neurocrit Care. 2012;16(1):95–101.
  • 10. Love PF, Tepas JJ, Wludyka PS, Masnita-Iusan C. Fall-related pediatric brain injuries: The role of race, Age, and sex. In: Journal of Trauma - Injury, Infection and Critical Care. 2009.
  • 11. Işik HS, Gökyar A, Yildiz Ö, Bostanci U, Özdemir C. Pediatric head injuries, retrospective analysis of 851 patients: An epidemiological study. Ulus Travma ve Acil Cerrahi Derg. 2011 Mar 1;17(2):166–72.
  • 12. Şimşek O, Hiçdönmez T, Hamamcioǧlu MK, Kilinçer C, Parsak T, Tiryaki M, et al. Pediatric head injuries: A retrospective analysis of 280 patients. Ulus Travma ve Acil Cerrahi Derg. 2005;11(4):310–7.
  • 13. Verma S, Lal N, Lodha R, Murmu L. Childhood trauma profile at a tertiary care hospital in India. Indian Pediatr. 2009;46(2):168–71.
  • 14. Ökten Aİ, Yalman M, Kaptanoğlu E, Gül B, Gezici AR Sİ. Pediatrik kafa travmaları . Ulusal Travma Dergisi. 1996; 2:94–9.
  • 15. Liu-Deryke X, Collingridge DS, Orme J, Roller D, Zurasky J, Rhoney DH. Clinical impact of early hyperglycemia during acute phase of traumatic brain injury. Neurocrit Care 2009;11(2):151–7.
  • 16. Zhang Z, Yan J, Shi H. Role of Hypoxia Inducible Factor 1 in Hyperglycemia-Exacerbated Blood-Brain Barrier Disruption in Ischemic Stroke. Neurobiol Dis. 2016;95:82–92.
  • 17. Dietrich DW, Alonso O, Busto R. Moderate hyperglycemia worsens acute blood-brain barrier injury after forebrain ischemia in rats. Stroke. 1993;24(1):111–6.
  • 18. Li PA, He QP, Ouyang YB, Liu CL, Hu BR, Siesjö BK. Early release of cytochrome C and activation of caspase-3 in hyperglycemic rats subjected to transient forebrain ischemia. Brain Res. 2001;896(1–2):69–76.
  • 19. Widmer H, Abiko H, Faden AI, James TL, Weinstein PR. Effects of hyperglycemia on the time course of changes in energy metabolism and pH during global cerebral ischemia and reperfusion in rats: Correlation of 1H and 31P NMR spectroscopy with fatty acid and excitatory amino acid levels. J Cereb Blood Flow Metab. 1992;12(3):456–68.
  • 20. Folbergrova J, Memezawa H, Smith ML, Siesjo BK. Focal and perifocal changes in tissue energy state during middle cerebral artery occlusion in normo- and hyperglycemic rats. J Cereb Blood Flow Metab. 1992;12(1):25–33.
  • 21. Back T, Hoehn-Berlage M, Kohno K, Hossmann KA. Diffusion nuclear magnetic resonance imaging in experimental stroke correlation with cerebral metabolites. Stroke. 1994;25(2):494–500.
  • 22. Song EC, Chu K, Jeong SW, Jung KH, Kim SH, Kim M, et al. Hyperglycemia exacerbates brain edema and perihematomal cell death after intracerebral hemorrhage. Stroke. 2003;34(9):2215–20.
  • 23. Rao AK, Chouhan V, Chen X, Sun L, Boden G. Activation of the tissue factor pathway of blood coagulation during prolonged hyperglycemia in young healthy men. Diabetes. 1999;48(5):1156–61.
  • 24. Pandolfi A, Giaccari A, Cilli C, Alberta MM, Morviducci L, De Filippis EA, et al. Acute hyperglycemia and acute hyperinsulinemia decrease plasma fibrinolytic activity and increase plasminogen activator inhibitor type 1 in the rat. Acta Diabetol. 2001;38(2):71–6.
  • 25. Golden SH, Hill-Briggs F, Williams K, Stolka K, Mayer RS. Management of diabetes during acute stroke and inpatient stroke rehabilitation. Arch Phys Med Rehabil. 2005;86(12):2377–84.
  • 26. Shi J, Dong B, Mao Y, Guan W, Cao J, Zhu R, et al. Review: Traumatic brain injury and hyperglycemia, a potentially modifiable risk factor. Vol. 7, Oncotarget. 2016. p. 71052–61.
  • 27. Chong SL, Harjanto S, Testoni D, Ng ZM, Low CYD, Lee KP, et al. Early hyperglycemia in pediatric traumatic brain injury predicts for mortality, prolonged duration of mechanical ventilation, and intensive care stay. Int J Endocrinol. 2015;2015.
  • 28. Svedung Wettervik TM, Engquist H, Lenell S, Howells T, Hillered L, Rostami E, et al. Systemic Hyperthermia in Traumatic Brain Injury - Relation to Intracranial Pressure Dynamics, Cerebral Energy Metabolism, and Clinical Outcome. J Neurosurg Anesthesiol. 2021;33(4):329–36.
  • 29. Alkan T, Kahveci N, Buyukuysal L, Korfali E, Ozluk K. Neuroprotective effects of MK 801 and hypothermia used alone and in combination in hypoxic-ischemic brain injury in neonatal rats. Arch Physiol Biochem. 2001;109(2):135–44.
  • 30. Kahveci FS, Kahveci N, Alkan T, Goren B, Korfali E, Ozluk K. Propofol versus isoflurane anesthesia under hypothermic conditions: Effects on intracranial pressure and local cerebral blood flow after diffuse traumatic brain injury in the rat. Surg Neurol. 2001;56(3):206–14.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Tıbbi Fizyoloji
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Ayşen Çakır 0000-0001-7729-7373

Vahide Aslıhan Durak 0000-0003-0836-7862

M Özgür Taşkapılıoğlu 0000-0001-5472-9065

Güven Özkaya 0000-0003-0297-846X

Nevzat Kahveci 0000-0003-0841-8201

Yayımlanma Tarihi 15 Eylül 2022
Kabul Tarihi 14 Haziran 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 48 Sayı: 2

Kaynak Göster

APA Çakır, A., Durak, V. A., Taşkapılıoğlu, M. Ö., Özkaya, G., vd. (2022). Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi ve Vücut Sıcaklığının Prognoza Etkisi. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 48(2), 137-141. https://doi.org/10.32708/uutfd.1066850
AMA Çakır A, Durak VA, Taşkapılıoğlu MÖ, Özkaya G, Kahveci N. Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi ve Vücut Sıcaklığının Prognoza Etkisi. Uludağ Tıp Derg. Eylül 2022;48(2):137-141. doi:10.32708/uutfd.1066850
Chicago Çakır, Ayşen, Vahide Aslıhan Durak, M Özgür Taşkapılıoğlu, Güven Özkaya, ve Nevzat Kahveci. “Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi Ve Vücut Sıcaklığının Prognoza Etkisi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48, sy. 2 (Eylül 2022): 137-41. https://doi.org/10.32708/uutfd.1066850.
EndNote Çakır A, Durak VA, Taşkapılıoğlu MÖ, Özkaya G, Kahveci N (01 Eylül 2022) Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi ve Vücut Sıcaklığının Prognoza Etkisi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48 2 137–141.
IEEE A. Çakır, V. A. Durak, M. Ö. Taşkapılıoğlu, G. Özkaya, ve N. Kahveci, “Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi ve Vücut Sıcaklığının Prognoza Etkisi”, Uludağ Tıp Derg, c. 48, sy. 2, ss. 137–141, 2022, doi: 10.32708/uutfd.1066850.
ISNAD Çakır, Ayşen vd. “Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi Ve Vücut Sıcaklığının Prognoza Etkisi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48/2 (Eylül 2022), 137-141. https://doi.org/10.32708/uutfd.1066850.
JAMA Çakır A, Durak VA, Taşkapılıoğlu MÖ, Özkaya G, Kahveci N. Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi ve Vücut Sıcaklığının Prognoza Etkisi. Uludağ Tıp Derg. 2022;48:137–141.
MLA Çakır, Ayşen vd. “Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi Ve Vücut Sıcaklığının Prognoza Etkisi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 48, sy. 2, 2022, ss. 137-41, doi:10.32708/uutfd.1066850.
Vancouver Çakır A, Durak VA, Taşkapılıoğlu MÖ, Özkaya G, Kahveci N. Çocukluk Çağı Kafa Travmalarında Kan Glukoz Düzeyi ve Vücut Sıcaklığının Prognoza Etkisi. Uludağ Tıp Derg. 2022;48(2):137-41.

ISSN: 1300-414X, e-ISSN: 2645-9027

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