Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children: Association with severity of injury and excitotoxicity

Courtney Robertson, M. J. Bell, P. M. Kochanek, P. D. Adelson, R. A. Ruppel, J. A. Carcillo, S. R. Wisniewski, Z. Mi, K. L. Janesko, R. S B Clark, D. W. Marion, S. H. Graham, E. K. Jackson

Research output: Contribution to journalArticle

Abstract

Objectives: To measure adenosine concentration in the cerebrospinal fluid of infants and children after severe traumatic brain injury and to evaluate the contribution of patient age, Glasgow Coma Scale score, mechanism of injury, Glasgow Outcome Score, and time after injury to cerebrospinal fluid adenosine concentrations. To evaluate the relationship between cerebrospinal fluid adenosine and glutamate concentrations in this population. Design: Prospective survey. Setting: Pediatric intensive care unit in a university-based children's hospital. Patients: Twenty-seven critically ill infants and children who had severe traumatic brain injury (Glasgow Coma Scale 4 and time after injury (both p <.005). Cerebrospinal fluid adenosine concentration was not independently associated with either age (≤4 vs. >4 yrs), mechanism of injury (abuse vs. other), or Glasgow Outcome Score (good/moderately disabled vs. severely disabled, vegetative, or dead). Of the 27 patients studied, 18 had cerebrospinal fluid glutamate concentration previously quantified by high-pressure liquid chromatography. There was a strong association between increases in cerebrospinal fluid adenosine and glutamate concentrations (p <.005) after injury. Conclusions: Cerebrospinal fluid adenosine concentration is increased in a time- and severity-dependent manner in infants and children after severe head injury. The association between cerebrospinal fluid adenosine and glutamate concentrations may reflect an endogenous attempt at neuroprotection against excitotoxicity after severe traumatic brain injury.

Original languageEnglish (US)
Pages (from-to)2287-2293
Number of pages7
JournalCritical Care Medicine
Volume29
Issue number12
StatePublished - 2001
Externally publishedYes

Fingerprint

Adenosine
Cerebrospinal Fluid
Wounds and Injuries
Glutamic Acid
Glasgow Coma Scale
Pediatric Intensive Care Units
Traumatic Brain Injury
Craniocerebral Trauma
Critical Illness
High Pressure Liquid Chromatography
Population

Keywords

  • Child abuse
  • Glasgow Coma Scale
  • Glutamate
  • Head injury
  • Pediatrics
  • Purine
  • Shaken baby syndrome

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Robertson, C., Bell, M. J., Kochanek, P. M., Adelson, P. D., Ruppel, R. A., Carcillo, J. A., ... Jackson, E. K. (2001). Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children: Association with severity of injury and excitotoxicity. Critical Care Medicine, 29(12), 2287-2293.

Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children : Association with severity of injury and excitotoxicity. / Robertson, Courtney; Bell, M. J.; Kochanek, P. M.; Adelson, P. D.; Ruppel, R. A.; Carcillo, J. A.; Wisniewski, S. R.; Mi, Z.; Janesko, K. L.; Clark, R. S B; Marion, D. W.; Graham, S. H.; Jackson, E. K.

In: Critical Care Medicine, Vol. 29, No. 12, 2001, p. 2287-2293.

Research output: Contribution to journalArticle

Robertson, C, Bell, MJ, Kochanek, PM, Adelson, PD, Ruppel, RA, Carcillo, JA, Wisniewski, SR, Mi, Z, Janesko, KL, Clark, RSB, Marion, DW, Graham, SH & Jackson, EK 2001, 'Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children: Association with severity of injury and excitotoxicity', Critical Care Medicine, vol. 29, no. 12, pp. 2287-2293.
Robertson, Courtney ; Bell, M. J. ; Kochanek, P. M. ; Adelson, P. D. ; Ruppel, R. A. ; Carcillo, J. A. ; Wisniewski, S. R. ; Mi, Z. ; Janesko, K. L. ; Clark, R. S B ; Marion, D. W. ; Graham, S. H. ; Jackson, E. K. / Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children : Association with severity of injury and excitotoxicity. In: Critical Care Medicine. 2001 ; Vol. 29, No. 12. pp. 2287-2293.
@article{628cb1e3d52b4a46a78687e30d90c541,
title = "Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children: Association with severity of injury and excitotoxicity",
abstract = "Objectives: To measure adenosine concentration in the cerebrospinal fluid of infants and children after severe traumatic brain injury and to evaluate the contribution of patient age, Glasgow Coma Scale score, mechanism of injury, Glasgow Outcome Score, and time after injury to cerebrospinal fluid adenosine concentrations. To evaluate the relationship between cerebrospinal fluid adenosine and glutamate concentrations in this population. Design: Prospective survey. Setting: Pediatric intensive care unit in a university-based children's hospital. Patients: Twenty-seven critically ill infants and children who had severe traumatic brain injury (Glasgow Coma Scale 4 and time after injury (both p <.005). Cerebrospinal fluid adenosine concentration was not independently associated with either age (≤4 vs. >4 yrs), mechanism of injury (abuse vs. other), or Glasgow Outcome Score (good/moderately disabled vs. severely disabled, vegetative, or dead). Of the 27 patients studied, 18 had cerebrospinal fluid glutamate concentration previously quantified by high-pressure liquid chromatography. There was a strong association between increases in cerebrospinal fluid adenosine and glutamate concentrations (p <.005) after injury. Conclusions: Cerebrospinal fluid adenosine concentration is increased in a time- and severity-dependent manner in infants and children after severe head injury. The association between cerebrospinal fluid adenosine and glutamate concentrations may reflect an endogenous attempt at neuroprotection against excitotoxicity after severe traumatic brain injury.",
keywords = "Child abuse, Glasgow Coma Scale, Glutamate, Head injury, Pediatrics, Purine, Shaken baby syndrome",
author = "Courtney Robertson and Bell, {M. J.} and Kochanek, {P. M.} and Adelson, {P. D.} and Ruppel, {R. A.} and Carcillo, {J. A.} and Wisniewski, {S. R.} and Z. Mi and Janesko, {K. L.} and Clark, {R. S B} and Marion, {D. W.} and Graham, {S. H.} and Jackson, {E. K.}",
year = "2001",
language = "English (US)",
volume = "29",
pages = "2287--2293",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children

T2 - Association with severity of injury and excitotoxicity

AU - Robertson, Courtney

AU - Bell, M. J.

AU - Kochanek, P. M.

AU - Adelson, P. D.

AU - Ruppel, R. A.

AU - Carcillo, J. A.

AU - Wisniewski, S. R.

AU - Mi, Z.

AU - Janesko, K. L.

AU - Clark, R. S B

AU - Marion, D. W.

AU - Graham, S. H.

AU - Jackson, E. K.

PY - 2001

Y1 - 2001

N2 - Objectives: To measure adenosine concentration in the cerebrospinal fluid of infants and children after severe traumatic brain injury and to evaluate the contribution of patient age, Glasgow Coma Scale score, mechanism of injury, Glasgow Outcome Score, and time after injury to cerebrospinal fluid adenosine concentrations. To evaluate the relationship between cerebrospinal fluid adenosine and glutamate concentrations in this population. Design: Prospective survey. Setting: Pediatric intensive care unit in a university-based children's hospital. Patients: Twenty-seven critically ill infants and children who had severe traumatic brain injury (Glasgow Coma Scale 4 and time after injury (both p <.005). Cerebrospinal fluid adenosine concentration was not independently associated with either age (≤4 vs. >4 yrs), mechanism of injury (abuse vs. other), or Glasgow Outcome Score (good/moderately disabled vs. severely disabled, vegetative, or dead). Of the 27 patients studied, 18 had cerebrospinal fluid glutamate concentration previously quantified by high-pressure liquid chromatography. There was a strong association between increases in cerebrospinal fluid adenosine and glutamate concentrations (p <.005) after injury. Conclusions: Cerebrospinal fluid adenosine concentration is increased in a time- and severity-dependent manner in infants and children after severe head injury. The association between cerebrospinal fluid adenosine and glutamate concentrations may reflect an endogenous attempt at neuroprotection against excitotoxicity after severe traumatic brain injury.

AB - Objectives: To measure adenosine concentration in the cerebrospinal fluid of infants and children after severe traumatic brain injury and to evaluate the contribution of patient age, Glasgow Coma Scale score, mechanism of injury, Glasgow Outcome Score, and time after injury to cerebrospinal fluid adenosine concentrations. To evaluate the relationship between cerebrospinal fluid adenosine and glutamate concentrations in this population. Design: Prospective survey. Setting: Pediatric intensive care unit in a university-based children's hospital. Patients: Twenty-seven critically ill infants and children who had severe traumatic brain injury (Glasgow Coma Scale 4 and time after injury (both p <.005). Cerebrospinal fluid adenosine concentration was not independently associated with either age (≤4 vs. >4 yrs), mechanism of injury (abuse vs. other), or Glasgow Outcome Score (good/moderately disabled vs. severely disabled, vegetative, or dead). Of the 27 patients studied, 18 had cerebrospinal fluid glutamate concentration previously quantified by high-pressure liquid chromatography. There was a strong association between increases in cerebrospinal fluid adenosine and glutamate concentrations (p <.005) after injury. Conclusions: Cerebrospinal fluid adenosine concentration is increased in a time- and severity-dependent manner in infants and children after severe head injury. The association between cerebrospinal fluid adenosine and glutamate concentrations may reflect an endogenous attempt at neuroprotection against excitotoxicity after severe traumatic brain injury.

KW - Child abuse

KW - Glasgow Coma Scale

KW - Glutamate

KW - Head injury

KW - Pediatrics

KW - Purine

KW - Shaken baby syndrome

UR - http://www.scopus.com/inward/record.url?scp=0035675518&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035675518&partnerID=8YFLogxK

M3 - Article

C2 - 11801827

AN - SCOPUS:0035675518

VL - 29

SP - 2287

EP - 2293

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 12

ER -