The Effect of Pre-, Intra- and Postoperative Blood Glucose on Outcomes of Patients with Traumatic Brain Injury

Traumatic brain injury is one of the important problems of world health with high mortality; probably, simultaneous hyperglycemia can intensify the harmful effects. Since there is no unique opinion in this regard, we aimed to study the effect of blood glucose at before, during and after operation on outcome of patients with traumatic brain injury.

A hundred patients with traumatic brain injury were studied during a prospective clinical trial study. We divided patients according to their preoperative blood glucose level to two groups of normo- and hyperglycemic. We measured and recorded blood glucose level during and after operation, in addition to the heart rate, blood pressure, saturation of oxygen (SpO2), duration of mechanical ventilation and outcome of patients in both groups.

Heart rate was significantly higher at 15th (P = 0.027), 60th (P = 0.018), 105th (P = 0.010) minutes and in recovery room (P = 0.006) in hyperglycemic patients; but as a general, the changes in heart rates were not significant in both groups (P = 0.610). There was no difference in SpO2 at different times. The mean arterial pressure (MAP) was higher at 45th (P = 0.025) and 60th (P = 0.016) minutes during the surgery; but as a general, there were no significant difference in MAP between the two groups (P = 0.850). Duration of mechanical ventilation was significantly longer in hyperglycemic patients (P = 0.009).

According to our findings, elevated blood glucose patients with traumatic brain injury may results in some intraoperative hemodynamic changes and affect their outcome. Therefore, monitoring of blood glucose in these patients is suggested.