Improvement of Blood-Brain Barrier Integrity in Traumatic Brain Injury and Hemorrhagic Shock Following Treatment With Valproic Acid and Fresh Frozen Plasma

Critical Care Medicine
Vahagn C NikolianHasan B Alam

Abstract

Combined traumatic brain injury and hemorrhagic shock are highly lethal. Following injuries, the integrity of the blood-brain barrier can be impaired, contributing to secondary brain insults. The status of the blood-brain barrier represents a potential factor impacting long-term neurologic outcomes in combined injuries. Treatment strategies involving plasma-based resuscitation and valproic acid therapy have shown efficacy in this setting. We hypothesize that a component of this beneficial effect is related to blood-brain barrier preservation. Following controlled traumatic brain injury, hemorrhagic shock, various resuscitation and treatment strategies were evaluated for their association with blood-brain barrier integrity. Analysis of gene expression profiles was performed using Porcine Gene ST 1.1 microarray. Pathway analysis was completed using network analysis tools (Gene Ontology, Ingenuity Pathway Analysis, and Parametric Gene Set Enrichment Analysis). Female Yorkshire swine were subjected to controlled traumatic brain injury and 2 hours of hemorrhagic shock (40% blood volume, mean arterial pressure 30-35 mmHg). Subjects were resuscitated with 1) normal saline, 2) fresh frozen plasma, 3) hetastarch, 4) fresh frozen plasma ...Continue Reading

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Citations

Jan 3, 2019·Shock·Aaron M WilliamsHasan B Alam
May 14, 2020·International Journal of Molecular Sciences·Alison Cash, Michelle H Theus
Jun 17, 2020·Molecular Neurobiology·Steinunn Sara HelgudottirTorben Moos
Nov 14, 2018·Intensive Care Medicine Experimental·Sophie Dunberry-PoissantEmmanuel Charbonney
Jul 1, 2019·Neuroscience and Biobehavioral Reviews·Andrew R MayerSheila M Alonzo
Jun 8, 2021·Frontiers in Immunology·Colleen N BodnarAdam D Bachstetter
Aug 3, 2021·Frontiers in Cell and Developmental Biology·Nuria VillalbaSarah Y Yuan
Jul 27, 2021·Frontiers in Veterinary Science·Armi Pigott, Elke Rudloff

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