Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients

INTRODUCTION: Hyperosmotic therapy with mannitol is frequently used for treatment cerebral edema, and 320 mOsm/kg H2O has been recommended as a high limit for therapeutic plasma osmolality. However, plasma hyperosmolality may impair cardiac function, increasing the risk of cardiac events. The aim of...

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Autores: Dabrowski, Wojciech, Siwicka-Gieroba, Dorota, Robba, Chiara, Badenes, Rafael, Bialy, Mateusz, Iwaniuk, Paulina, Schlegel, Todd T, Jaroszynski, Andrzej
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p4434
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/4434
Access Level:acceso abierto
Palabra clave:traumatic brain injury
cardiac arrhythmias
plasma osmolality
osmolar gap
electrocardiography
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spelling Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury PatientsDabrowski, WojciechSiwicka-Gieroba, DorotaRobba, ChiaraBadenes, RafaelBialy, MateuszIwaniuk, PaulinaSchlegel, Todd TJaroszynski, Andrzejtraumatic brain injurycardiac arrhythmiasplasma osmolalityosmolar gapelectrocardiographyINTRODUCTION: Hyperosmotic therapy with mannitol is frequently used for treatment cerebral edema, and 320 mOsm/kg H2O has been recommended as a high limit for therapeutic plasma osmolality. However, plasma hyperosmolality may impair cardiac function, increasing the risk of cardiac events. The aim of this study was to analyze the relation between changes in plasma osmolality and electrocardiographic variables and cardiac arrhythmia in patients treated for isolated traumatic brain injury (iTBI).; METHODS: Adult iTBI patients requiring mannitol infusion following cerebral edema, and with a Glasgow Coma Score below 8, were included. Plasma osmolality was measured with Osmometr 800 CLG. Spatial QRS-T angle (spQRS-T), corrected QT interval (QTc) and STJ segment were calculated from digital resting 12-lead ECGs and analyzed in relation to four levels of plasma osmolality: A) <280 mOsm/kg H2O; B) 280-295 mOsm/kg H2O; C) 295-310 mOsm/kg H2O; and D) >310 mOsm/kg H2O. All parameters were measured during five consecutive days of treatment.; RESULTS: 94 patients aged 18-64 were studied. Increased plasma osmolality correlated with prolonged QTc (p < 0.001), intensified disorders in STJ and increased the risk for cardiac arrhythmia. Moreover, plasma osmolality >313 mOms/kg H2O significantly increased the risk of QTc prolongation >500 ms.; CONCLUSION: In patients treated for iTBI, excessively increased plasma osmolality contributes to electrocardiographic disorders including prolonged QTc, while also correlating with increased risk for cardiac arrhythmias.MDPI2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/4434Journal of Clinical MedicineISSN: 20770383reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p44342026-06-07T16:35:31Z
dc.title.none.fl_str_mv Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
title Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
spellingShingle Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
Dabrowski, Wojciech
traumatic brain injury
cardiac arrhythmias
plasma osmolality
osmolar gap
electrocardiography
title_short Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
title_full Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
title_fullStr Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
title_full_unstemmed Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
title_sort Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients
dc.creator.none.fl_str_mv Dabrowski, Wojciech
Siwicka-Gieroba, Dorota
Robba, Chiara
Badenes, Rafael
Bialy, Mateusz
Iwaniuk, Paulina
Schlegel, Todd T
Jaroszynski, Andrzej
author Dabrowski, Wojciech
author_facet Dabrowski, Wojciech
Siwicka-Gieroba, Dorota
Robba, Chiara
Badenes, Rafael
Bialy, Mateusz
Iwaniuk, Paulina
Schlegel, Todd T
Jaroszynski, Andrzej
author_role author
author2 Siwicka-Gieroba, Dorota
Robba, Chiara
Badenes, Rafael
Bialy, Mateusz
Iwaniuk, Paulina
Schlegel, Todd T
Jaroszynski, Andrzej
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv traumatic brain injury
cardiac arrhythmias
plasma osmolality
osmolar gap
electrocardiography
topic traumatic brain injury
cardiac arrhythmias
plasma osmolality
osmolar gap
electrocardiography
description INTRODUCTION: Hyperosmotic therapy with mannitol is frequently used for treatment cerebral edema, and 320 mOsm/kg H2O has been recommended as a high limit for therapeutic plasma osmolality. However, plasma hyperosmolality may impair cardiac function, increasing the risk of cardiac events. The aim of this study was to analyze the relation between changes in plasma osmolality and electrocardiographic variables and cardiac arrhythmia in patients treated for isolated traumatic brain injury (iTBI).; METHODS: Adult iTBI patients requiring mannitol infusion following cerebral edema, and with a Glasgow Coma Score below 8, were included. Plasma osmolality was measured with Osmometr 800 CLG. Spatial QRS-T angle (spQRS-T), corrected QT interval (QTc) and STJ segment were calculated from digital resting 12-lead ECGs and analyzed in relation to four levels of plasma osmolality: A) <280 mOsm/kg H2O; B) 280-295 mOsm/kg H2O; C) 295-310 mOsm/kg H2O; and D) >310 mOsm/kg H2O. All parameters were measured during five consecutive days of treatment.; RESULTS: 94 patients aged 18-64 were studied. Increased plasma osmolality correlated with prolonged QTc (p < 0.001), intensified disorders in STJ and increased the risk for cardiac arrhythmia. Moreover, plasma osmolality >313 mOms/kg H2O significantly increased the risk of QTc prolongation >500 ms.; CONCLUSION: In patients treated for iTBI, excessively increased plasma osmolality contributes to electrocardiographic disorders including prolonged QTc, while also correlating with increased risk for cardiac arrhythmias.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/4434
url https://incliva.portalinvestigacion.com/publicaciones/4434
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Journal of Clinical Medicine
ISSN: 20770383
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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