Brain Death, Brain Edema, Brain Hemorrhage, Brain Injuries
Conditions
Keywords
Resting energy expenditure (REE), Brain Death, Brain injuries
Brief summary
The study will examine the resting energy need (REE) in patients suffering from brain damage. For the measurement of REE will be used a metabolic computer (which with continuous recording of breath-to-breath volume (Vt), respiratory rate (RR) of ventilation per minute volume (MV) ), of inhaled and exhaled gases (O2 and CO2) has the ability to calculate the values of VO2, VCO2 and with the help of equations the values of REE and RQ.
Detailed description
This is a retrospective observational study concerning patients suffering from brain damage. All the patients suffering from brain damage are monitored in order to examine their resting energy needs (REE). For the measurement of REE the metabolic computer (Medical Graphics, Ultima CCM, Minneapolis, USA) is used. The main purpose of this study is to reveal the (REE) changing in patients with brain death semiology and examine if the REE changes could be related to the outcome of a patient with intracranial pathology. Moreover the study will examine if the changes in REE measurement are related to changes in flow velocities in the midbrain. Any measurement shall be preceded by calibration of the metabolic computer pneumotachograph with a 3-liter syringe with an acceptable error of less than 9 ml / lit. The metabolic unit is calibrated for VO2 measurements with two calibration cylinders containing 21% and 12% O2 and for VCO2 measurements with calibration gases containing 5% and 0% CO2 respectively. The measurement of flow velocities in the middle cerebral artery will be done with the transcranial Doppler using a low frequency (2 MHz) ultrasound head After their final diagnosis (brain death or not) the patients' characteristics will be compared according to the categorization as brain dead or not.
Interventions
DIAGNOSTIC_TESTREE - Resting Energy Expenditure
REEs represent 60-70% of the needs for a sedentary person and 50% of physically active people. For the measurement of REE will be used the metabolic computer (Medical Graphics, Ultima CCM, Minneapolis, USA), which with continuous recording of breath-to-breath volume (Vt), respiratory rate (RR) of ventilation per minute volume (MV) ), of inhaled and exhaled gases (O2 and CO2) has the ability to calculate the values of VO2, VCO2 and with the help of equations the values of REE and RQ. All patients in the study will be monitored with the metabolic computer. Their measurements will be recorded every day during their stay in the ICU.
DIAGNOSTIC_TESTTranscranial Doppler
The measurement of flow velocities in the middle cerebral artery will be done with the transcranial Doppler using a low frequency (2 MHz) ultrasound head. All patients entering the study will be examined with the TCD every day during their stay in the ICU.
Sponsors
Papageorgiou General Hospital
Aristotle University Of Thessaloniki
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients entering the ICU * Age 18-90 years old * Clinical Diagnosis of brain damage * GCS \<=8
Exclusion criteria
* Patients \<18 years old and \>90 years old, * Past history CNS disease (alzheimer's disease, multiple sclerosis, brain tumor, aneurysm) in the last 3 years * Past history of cachexia due to cancer
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| REE changes | Day 0 (upon entry to ICU) up to 30 days | Changes in REE in patients with brain damage |
| MCA changes | Day 0 (upon entry to ICU) up to 30 days | Changes in flow rates in Median Cerebral Artery (MCA) in patients with brain damage |
| REE and MCA correlation | Day 0 (upon entry to ICU) up to 30 days | Correlate the REE changes with those in flow rates in MCA |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prognostic value of REE | Day 0 (upon entry to ICU) up to 30 days | Compare the values of REE upon entry in the ICU in patients with final diagnosis as brain dead or not |
Countries
Greece
Outcome results
None listed