Secondary brain injury in trauma patients: the effects of remote ischemic conditioning

The Journal of Trauma and Acute Care Surgery
Bellal JosephPeter Rhee

Abstract

Management of traumatic brain injury (TBI) is focused on preventing secondary brain injury. Remote ischemic conditioning (RIC) is an established treatment modality that has been shown to improve patient outcomes secondary to inflammatory insults. The aim of our study was to assess whether RIC in trauma patients with severe TBI could reduce secondary brain injury. This prospective consented interventional trial included all TBI patients admitted to our Level 1 trauma center with an intracranial hemorrhage and a Glasgow Coma Scale (GCS) score of 8 or lower on admission. In each patient, four cycles of RIC were performed within 1 hour of admission. Each cycle consisted of 5 minutes of controlled upper limb (arm) ischemia followed by 5 minutes of reperfusion using a blood pressure cuff. Serum biomarkers of acute brain injury, S-100B, and neuron-specific enolase (NSE) were measured at 0, 6, and 24 hours. Outcome measure was reduction in the level of serum biomarkers after RIC. A total of 40 patients (RIC, 20; control, 20) were enrolled. The mean (SD) age was 46.15 (18.64) years, the median GCS score was 8 (interquartile range, 3-8), and the median head Abbreviated Injury Scale (AIS) score was 3 (interquartile range, 3-5), and there ...Continue Reading

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Citations

Mar 27, 2016·Critical Care Clinics·Thomas W CarverAmit Taneja
Nov 21, 2015·Nature Reviews. Neurology·David C HessXunming Ji
Jun 14, 2017·The Journal of Trauma and Acute Care Surgery·Alexander J SandweissBellal Joseph
Jun 21, 2017·Journal of Cardiovascular Pharmacology and Therapeutics·Kirk N Garratt, Boris Leschinsky
Feb 15, 2018·The Journal of Trauma and Acute Care Surgery·Viraj PanditBellal Joseph
Jul 6, 2018·The Cochrane Database of Systematic Reviews·Wenbo ZhaoXunming Ji
Aug 20, 2019·The Journal of Trauma and Acute Care Surgery·Muhammad ZeeshanBellal Joseph
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Mar 1, 2020·International Journal of Environmental Research and Public Health·Francisco Martín-RodríguezJosé Luis Martín-Conty
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Nov 6, 2015·Current Opinion in Critical Care·Bellal JosephPeter Rhee
Aug 25, 2017·Journal of Neuroscience Research·Bellal JosephPeter Rhee
Sep 11, 2021·Physiological Research·J Burda, R Burda

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Brain Injury & Trauma

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