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Prediktor Outcome pada Cedera Kepala Traumatik (Glukosa, Laktat, SID, MDA, Cerebral Extraction Ratio for Oxygen/CERO2) [(Predictor of Outcome in Traumatic Brain Injury (Glucosa, Lactate, SID, MDA, Cerebral Extraction Ratio for Oxygen/CER02)]

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Background and Objective : The tissue has a difJerent requirement for glucose. The brain has the greatest need for glucose. The brain is very susceptible to ischemia suggests that the brain has a high metabolic rate. Mechanism of ischemic injury is the biochemical changes and physiological changes that occur due to circulatory disturbances. Such changes as: (1) The loss of high energy phosphate, (2) acidosis due to anaerobic process that produces lactic and (3) No Reflow because of brain edema. The use of lactate levels as an indicator of tissue ischemia, has been widely applied in various studies. The results of these studies indicate that the levels of lactate can be used as an early marker for predicting the risk of complications, postoperative mortality and the incidence of MOF (Multiple Organ Failure). Latelyalot of talk about the relationship SID changes with poor clinical outcome. They found that the SID / SIG is a strong predictor of patient outcome. Oxidative stress is one of the mechanisms involved in neuronal damage due to ischemia and reperfusion, presumably due to the formation of lipid peroxidation. MDA is used as a marker of lipid peroxidation, especially for processes associated with oxidative stress. CER02 can be used as an indicator of cerebral ischemia. Subjects and Method: Eleven patients with a traumatic head injury initial GCS 5-12 who underwent craniotomy with evacuation operations, was observed on levels of glucose, lactate, SID, MDA, the CER02 and the outcome (the APS Score) from pre surgery to 3 days after surgery in the ICU Blood samples taken from the jugular internal vein and radial artery. Observations were analyzed to see the relationship between the variables with the outcome observations.
Results: Found a strong relationship between the variable: levels of lactate, MDA and CER02 on patient outcomes in general. But there are variations between them according to the conditions when the analysis carried out observations. Day 2 is the most ideal time to see the effect on outcome of lactate levels whereas to see the relationship between the MDA and CER02 to outcome, the observation idealy taken on day 3.
Conclusion: The variables, levels of lactate, MDA and CER02 showed promising results as a predictor of outcome in patients with traumatic brain injury after craniotomy, although not yet to be concluded and is widely used as a reference. Need a multicentre study with more number of samples and good research design to get the results that can really make a reference in a broad range of predictor variables and the observations so as to provide good information about the prognosis of outcome of patients with traumatic brain injury, who remain based on the pathophysiology of brain injuryand cell death cascade of secondary brain injury.
Keywords: Levels ofGlucose; Lactate; SID; MDA; CER02; Predictors of Outcome, Traumatic Brain Injury (TBl)

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Call Number

Jurnal Neuroanestesia Indonesia, 1 (4) 2012 : 241-

Publisher

Bandung : Indonesian Society of Neuroanesthesia & Critical Care INA_SNACC., 2012

Collation

11p

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ISBN/ISSN

2088-9670

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Edition

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Subject(s)

brain injuries
GLUCOSE
LACTATES

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