The role of cerebrospinal fluid levels of neutrophil gelatinase-associated lipocalin (NGAL) and electroencephalography in the assessment of impaired consciousness in the context of infection.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Romanian Journal of Internal Medicine Pub Date : 2023-06-01 DOI:10.2478/rjim-2023-0005
Christina Platanaki, Themistoklis Paraskevas, Anna-Lisa Delastic, Christos Michailides, Anastasios Kantanis, Panagiotis Polychronopoulos, Markos Marangos, Dimitrios Velissaris
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引用次数: 1

Abstract

Introduction: The sepsis syndrome is potentially affecting several organs and systems irrespectively of the primary source of the infection. Alterations of the brain function in sepsis patients may result either from a primary central nervous system (CNS) infection or could be part of the sepsis-associated encephalopathy (SAE), a common complication of sepsis, characterized by a diffuse dysfunction of the brain due to an infection elsewhere in the body without overt CNS infection. Aim of the study was to evaluate the usefulness of electroencephalography and the biomarker neutrophil gelatinase-associated lipocalin (NGAL) when measured in the cerebrospinal fluid (CSF) in the management of these patients.

Methods: Patients presenting at the emergency department with altered mental status and signs of infection were included in this study. Among initial assessment and treatment of the patients based on the international guidelines for treating sepsis, NGAL was measured in the cerebrospinal fluid (CSF) using ELISA technique. Electroencephalography was performed when possible within 24 hours after admission and EEG abnormalities were recorded.

Results: 32 of 64 patients included in this study were diagnosed with central nervous system (CNS) infection. CSF NGAL was significantly higher in patients with CNS infection compared to patients without CNS infection (18.1 [5.1-71.1] vs 3.6 [1.2-11.6]; p<0.001). There was a trend for higher CSF NGAL in patients with EEG abnormalities, which did not reach statistical significance (p=0.106). CSF NGAL levels were similar between survivors and non-survivors (medians: 7.04 vs 11.79).

Conclusion: In patients presenting at the emergency department with altered mental status and signs of infection, CSF NGAL was significantly higher in patients with CSF infection. Its role in this acute setting should be evaluated further. CSF NGAL could be suggestive of EEG abnormalities.

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中性粒细胞明胶酶相关脂钙蛋白(NGAL)的脑脊液水平和脑电图在感染背景下评估意识受损中的作用。
简介:脓毒症综合征是潜在的影响几个器官和系统与感染的主要来源无关。败血症患者脑功能的改变可能是由原发性中枢神经系统(CNS)感染引起的,也可能是败血症相关脑病(SAE)的一部分,这是败血症的一种常见并发症,其特征是由于身体其他部位的感染而导致大脑弥漫性功能障碍,而没有明显的中枢神经系统感染。该研究的目的是评估脑电图和生物标志物中性粒细胞明胶酶相关脂钙蛋白(NGAL)在脑脊液(CSF)中测量在这些患者管理中的作用。方法:在急诊科出现精神状态改变和感染症状的患者纳入本研究。在根据国际脓毒症治疗指南对患者进行初步评估和治疗时,使用ELISA技术测量脑脊液(CSF)中的NGAL。入院后24小时内尽可能行脑电图检查,记录脑电图异常。结果:64例患者中32例被诊断为中枢神经系统(CNS)感染。中枢神经系统感染患者脑脊液NGAL显著高于未感染患者(18.1 [5.1-71.1]vs 3.6 [1.2-11.6];结论:在急诊科出现精神状态改变和感染体征的患者中,脑脊液感染患者的脑脊液NGAL显著升高。它在这种紧急情况下的作用应进一步评估。脑脊液NGAL可能提示脑电图异常。
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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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