Microvascular Barrier Biomarkers to Predict ICP Therapeutic Intensity After Severe TBI
Abstract
Severe traumatic brain injury (TBI) is a leading cause of death and disability that often occurs in conjunction with multiple other injuries, with and without hemorrhagic shock. Current guideline-based neurocritical care is designed to minimize intracranial hypertension using a tiered escalation in therapies, and seeks to avoid factors that aggravate the initial injury(hypotension and hypoxia). Our project seeks to measure the shed component of the microvascular barrier/glycocalyx(syndcan-1 and thrombomodulin) as a predictor of the edemagenic status of the post-TBI neurovascular unit. The ultimate goal is to be able to use a simple blood test that identifies the shed components of the microvascular barrier to rapidly identify the subset of severe TBI patients that require high intensity management the malignant ICP phenotype. The global hypothesis for this project is syndecan-1 release predicts the cerebral edema/therapeutic intensity level for intracranial hypertension phenotype after TBI. The presence of hemorrhagic shock/resuscitation exacerbates the edemagenic phenotype. To date, Phase1 of the study (n=25) has been completed. Phases 2/3 initiated enrollment in October 2021 (Year 3) and 10/50 patients have been enrolled through the end of Y3Q4. An additional patient has been enrolled in Y4.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2022
- Accession Number
- AD1190776
Entities
People
- Charles S. Jr Cox
Organizations
- University of Texas Health Science Center at Houston