DYNAMICS OF THE CONTENT OF WATER-ELECTROLYTE EXCHANGE IN PATIENTS WITH TRAUMATIC BRAIN INJURY DURING PERIOPERATIVE PERIOD

Abstract

Objective. To study the dynamics of the content of sodium, potassium, chloride, magnesium, calcium, phosphorus and iron of the serum and determine the possibility of their use as prognostic criteria for the outcome of treatment of patients with traumatic brain injury (TBI).Material and methods. Two groups were formed of 76 patients with TBI. Group 1 - 46 patients with a favorable outcome of treatment, group 2-30 patients with an adverse outcome. Serum electrolytes between groups were compared during the first 10 days after craniotomy at 7 stages of the study.Results. Between groups of patients differences in the content of K+ at the initial stage of the study (1-2 hours before surgery); Na+ and Cl- at stage 2 of the study (11 (6; 17) hours after surgery) and iron at 5-7 stages of the study (at the 5th, 7th and 10th day after the operation) were revealed. At all stages of the study when comparing groups of patients by the content of phosphorus, magnesium and calcium in the blood serum no significant differences were revealed.Conclusion. The best predictor of an adverse TBI outcome was serum iron on the 5th day after surgery – 2.5 (1.9; 5.2) mmol/l, AUC=0.73, Se=68.8, Sp=60%; on the 7th day after the operation - 3.7 (2.6; 4.3) mmol/l, AUC=0.73,Se=64.7%, Sp=72%; on the 10th day after the operation, 3.6 (1.9; 5.7) μmol/l, AUC=0.69, Se=73.7%, Sp=52.4%

Keywords

• water-electrolyte disturbances
• intensive care of traumatic brain injury
• serum iron
• neuroanesthesiology