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Augmented Renal Clearance in Traumatic Brain Injury: A Single-Center Observational Study of Atrial Natriuretic Peptide, Cardiac Output, and Creatinine Clearance

Overview of attention for article published in Journal of Neurotrauma, August 2016
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Title
Augmented Renal Clearance in Traumatic Brain Injury: A Single-Center Observational Study of Atrial Natriuretic Peptide, Cardiac Output, and Creatinine Clearance
Published in
Journal of Neurotrauma, August 2016
DOI 10.1089/neu.2015.4328
Pubmed ID
Authors

Andrew A. Udy, Paul Jarrett, Melissa Lassig-Smith, Janine Stuart, Therese Starr, Rachel Dunlop, Renae Deans, Jason A. Roberts, Siva Senthuran, Robert Boots, Kavita Bisht, Andrew C. Bulmer, Jeffrey Lipman

Abstract

Augmented renal clearance (ARC) is being increasingly described in neurocritical care practice. The mechanisms driving this phenomenon are largely unknown. The aim of this project was therefore to explore changes in renal function, cardiac output (CO), and atrial natriuretic peptide (ANP) concentrations in patients with isolated traumatic brain injury (TBI). This prospective observational cohort study was conducted in a tertiary level university affiliated ICU. Patients with normal plasma creatinine concentrations (< 120 μmol/L) at admission and no history of chronic kidney disease, admitted with isolated TBI, were eligible for enrolment. Continuous CO measures were obtained using arterial pulse waveform analysis. 8-h urinary creatinine clearances (CLCR) were used to quantify renal function. ANP concentrations in plasma were measured on alternate days. Data were collected from study enrolment until ICU discharge, death, or day 15, which ever came first. Eleven patients, contributing 100 ICU-days of physiological data were enrolled into the study. Most participants were young men, requiring mechanical ventilation. The median ICU length of stay was 9.6 [7.8-13.0] days. Elevated CLCR measures (> 150mL/min) were frequent, and appeared to parallel changes in CO. Plasma ANP concentrations were also significantly elevated over the study period (minimum value = 243 pg/mL). These data suggest that ARC is likely to complicate the care of TBI patients with normal plasma creatinine concentrations, and may be driven by associated cardiovascular changes, and/or elevated plasma ANP concentrations. However, significant additional research is required to further understand these findings.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 59 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 59 100%

Demographic breakdown

Readers by professional status Count As %
Other 10 17%
Student > Master 8 14%
Student > Bachelor 6 10%
Student > Doctoral Student 6 10%
Researcher 6 10%
Other 7 12%
Unknown 16 27%
Readers by discipline Count As %
Medicine and Dentistry 20 34%
Pharmacology, Toxicology and Pharmaceutical Science 13 22%
Neuroscience 2 3%
Psychology 2 3%
Nursing and Health Professions 1 2%
Other 0 0%
Unknown 21 36%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 June 2016.
All research outputs
#20,657,128
of 25,377,790 outputs
Outputs from Journal of Neurotrauma
#2,348
of 2,767 outputs
Outputs of similar age
#263,143
of 337,652 outputs
Outputs of similar age from Journal of Neurotrauma
#31
of 33 outputs
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We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.