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Azotaemia in severe head injury--central dysregulation or renal failure? | JoVE Visualize

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Azotaemia in severe head injury--central dysregulation or renal failure?

L Auer, H Holzer, H Tritthart

Acta Neurochirurgica|January 1, 1978

View abstract on PubMed

Summary

Serum urea levels significantly increase after severe craniocerebral trauma, with levels above 100 mg% indicating a poor prognosis. Uric acid and creatinine changes also correlate with patient outcomes.

Area of Science:

Biochemistry
Neurosurgery
Critical Care Medicine

Background:

Craniocerebral trauma can lead to significant metabolic disturbances.
Monitoring key biochemical markers is crucial for assessing patient prognosis.

Purpose of the Study:

To investigate the changes in serum urea, uric acid, and creatinine levels in patients with craniocerebral trauma.
To evaluate the prognostic value of these biochemical markers in severe head injuries.

Main Methods:

Serum levels of urea, uric acid, and creatinine were measured in 39 patients with craniocerebral trauma.
Levels were analyzed in relation to injury severity and patient survival.

Main Results:

Serum urea significantly increased by the seventh day post-injury (mean 237 mg%), showing strong prognostic value.
Patients with serum urea >100 mg% did not survive the acute stage.
Uric acid and creatinine increased significantly only in non-survivors, with creatinine rising after four days.

Conclusions:

A hypercatabolic state, possibly due to shock or central dysregulation, causes dissociated changes in urea, uric acid, and creatinine in the early phase.
Elevated serum creatinine after the initial four days suggests secondary renal failure.

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Azotaemia In Severe Head Injury--central Dysregulation Or Renal Failure?