ArticleAnnals of neurology2012
Real time estimation of brain water content in comatose patients.
Article in Annals of neurology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 26 citations in OpenAlex.
- Brain Hypoxia Is Associated With Neuroglial Injury in Humans Post-Cardiac Arrest.Circulation research · 2021Trial
- Invasive Neuromonitoring Modalities in the Pediatric Population.Neurocritical care · 2023Review
- Multimodal monitoring: practical recommendations (dos and don'ts) in challenging situations and uncertainty.Frontiers in neurology · 2023Review
- A Single-Scan, Rapid Whole-Brain Protocol for Quantitative Water Content Mapping With Neurobiological Implications.Frontiers in neurology · 2019Article
- Cerebral Edema After Cardiopulmonary Resuscitation: A Therapeutic Target Following Cardiac Arrest?Neurocritical care · 2018Review
- Neuroglucopenia and Metabolic Distress in Two Patients with Viral Meningoencephalitis: A Microdialysis Study.Neurocritical care · 2016Article
- Causal Structure of Brain Physiology after Brain Injury from Subarachnoid Hemorrhage.PloS one · 2016Article
- 23.4% Saline Decreases Brain Tissue Volume in Severe Hepatic Encephalopathy as Assessed by a Quantitative CT Marker.Critical care medicine · 2016Article
- Soluble Epoxide Hydrolase in Hydrocephalus, Cerebral Edema, and Vascular Inflammation After Subarachnoid Hemorrhage.Stroke · 2015Article
- Controversies and evolving new mechanisms in subarachnoid hemorrhage.Progress in neurobiology · 2014Article
- Multimodality monitoring in the neurointensive care unit: a special perspective for patients with stroke.Journal of stroke · 2013Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveAlthough brain swelling is an important cause of neurological deterioration, real time measurement of brain edema does not currently exist. Because thermal conductivity is proportional to percentage water content, we used the thermal conductivity constant to estimate brain water content (BWC).
methodsBetween June 2008 and November 2010, 36 comatose brain-injured patients underwent cerebral blood flow monitoring using a thermal diffusion probe in our neurocritical care unit. BWC was estimated hourly utilizing the measured thermal conductivity and the known temperature-adjusted thermal conductivity of water. In vitro experiments were performed to validate this formula using agar, glycerol, and water mixtures with different water content.
resultsThermal conductivity was highly correlated (R(2) = 0.99) and estimated water content was well correlated with actual water content (mean difference, 0.58%) in the in vitro preparations. The majority of the 36 patients (median age, 57 years; 44% female) had subarachnoid hemorrhage (n = 14) or cardiac arrest (n = 9). Initial BWC at the time of monitoring ranged from 67.3 to 85.5%. Brain regions appearing edematous on computed tomography showed higher estimated BWC than normal-appearing brain regions (79.1 vs 70.2%; p < 0.01). Bolus osmotherapy (20% mannitol or 23.4% hypertonic saline) decreased BWC from 77.2 ± 0.7% (mean ± standard error) at baseline to 76.1 ± 0.5% at 1 hour, 76.5 ± 0.3% at 2 hours, and 76.7 ± 0.2% at 3 hours (all p ≤ 0.03).
interpretationReal time monitoring of BWC is feasible using thermal conductivity. Further studies are needed to confirm the clinical utility of this technique.
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Registered trials
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