Kidney-Brain Link in Traumatic Brain Injury Patients? A preliminary report
Background Kidney hyperfiltration with augmented renal clearance is frequently observed in patients with traumatic brain injury. The aim of this study is to report preliminary findings about the relationship between brain autoregulation impairment, estimated kidney glomerular filtration rate and out...
Gespeichert in:
| Veröffentlicht in: | Neurocritical care 2015-04, Vol.22 (2), p.192-201 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 201 |
|---|---|
| container_issue | 2 |
| container_start_page | 192 |
| container_title | Neurocritical care |
| container_volume | 22 |
| creator | Dias, Celeste Gaio, A. Rita Monteiro, Elisabete Barbosa, Silvina Cerejo, António Donnelly, Joseph Felgueiras, Óscar Smielewski, Peter Paiva, José-Artur Czosnyka, Marek |
| description | Background
Kidney hyperfiltration with augmented renal clearance is frequently observed in patients with traumatic brain injury. The aim of this study is to report preliminary findings about the relationship between brain autoregulation impairment, estimated kidney glomerular filtration rate and outcome in critically ill patients after severe traumatic brain injury.
Methods
Data collected from a cohort of 18 consecutive patients with severe traumatic brain injury managed with ICP monitoring in a Neurocritical Care Unit, were retrospectively analyzed. Early morning blood tests were performed for routine chemistry assessments and we analyzed creatinine and estimated creatinine clearance, osmolarity, and sodium. Daily norepinephrine dose, protein intake, and water balance were documented. Time average of brain monitoring data (intracranial pressure, cerebral perfusion pressure, and cerebrovascular reactivity pressure index—PRx) were calculated for 6 h before blood sample tests. Patient outcome was evaluated using Glasgow outcome scale at 6-month follow-up, considering non
fatal
outcome if GOS ≥3 and
fatal
outcome if GOS |
| doi_str_mv | 10.1007/s12028-014-0045-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1676349450</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1664444506</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-e6151a89d6de1382c3ec33955286b4e327553e7a77225cd41fc4a8243848e2cb3</originalsourceid><addsrcrecordid>eNqNkU1rGzEQhkVJqJ20P6CXsJBLLko0-tw9Fce0-TKkB_csZO24rOvVutLuwf8-Mus2UAhElxHvPPMKzUvIF2DXwJi5ScAZLykDSRmTisIHMgWlNGWVhpPDXQLVlRATcpbShjFuKqM-kglX3AgFakoen5o64J7eRteEYtGE30Wuy-iG1vWNL0b9IWyGuC9-ZAlDn74Ws2IXcdu0TXBZj7jrYv-JnK7dNuHnYz0nP79_W87v6eL57mE-W1AvjeopalDgyqrWNYIouRfohaiU4qVeSRTcKCXQOGM4V76WsPbSlVyKUpbI_Uqck6vRdxe7PwOm3rZN8rjduoDdkCxoo4WspGLvQLXMRzGd0cv_0E03xJA_YnnFmWEahMgUjJSPXUoR13YXmzbvwAKzh0zsmInNmdhDJhbyzMXReVi1WP-b-BtCBvgIpNwKvzC-Pv226wtiX5OT</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2920706133</pqid></control><display><type>article</type><title>Kidney-Brain Link in Traumatic Brain Injury Patients? A preliminary report</title><source>MEDLINE</source><source>SpringerLink (Online service)</source><source>ProQuest Central</source><creator>Dias, Celeste ; Gaio, A. Rita ; Monteiro, Elisabete ; Barbosa, Silvina ; Cerejo, António ; Donnelly, Joseph ; Felgueiras, Óscar ; Smielewski, Peter ; Paiva, José-Artur ; Czosnyka, Marek</creator><creatorcontrib>Dias, Celeste ; Gaio, A. Rita ; Monteiro, Elisabete ; Barbosa, Silvina ; Cerejo, António ; Donnelly, Joseph ; Felgueiras, Óscar ; Smielewski, Peter ; Paiva, José-Artur ; Czosnyka, Marek</creatorcontrib><description>Background
Kidney hyperfiltration with augmented renal clearance is frequently observed in patients with traumatic brain injury. The aim of this study is to report preliminary findings about the relationship between brain autoregulation impairment, estimated kidney glomerular filtration rate and outcome in critically ill patients after severe traumatic brain injury.
Methods
Data collected from a cohort of 18 consecutive patients with severe traumatic brain injury managed with ICP monitoring in a Neurocritical Care Unit, were retrospectively analyzed. Early morning blood tests were performed for routine chemistry assessments and we analyzed creatinine and estimated creatinine clearance, osmolarity, and sodium. Daily norepinephrine dose, protein intake, and water balance were documented. Time average of brain monitoring data (intracranial pressure, cerebral perfusion pressure, and cerebrovascular reactivity pressure index—PRx) were calculated for 6 h before blood sample tests. Patient outcome was evaluated using Glasgow outcome scale at 6-month follow-up, considering non
fatal
outcome if GOS ≥3 and
fatal
outcome if GOS <3. Multiple linear regression models were used to study the crude and adjusted effects of the above variables on PRx throughout time.
Results
A total of 199 complete daily observations from 18 adult consecutive multiple trauma patients with severe traumatic brain injury were analyzed. At hospital admission, the median post-resuscitation Glasgow coma score was 6 (range 3–12), mean SAPSII score was 44.65 with predicted mortality of 36 %. Hospital mortality rate was 27 % and median GOS at 6 month after discharge was 3. Creatinine clearance (CrCl) was found to have a negative correlation with PRx (Pearson correlation—0.82), with statistically significant crude (
p
< 0.001) and adjusted (
p
= 0.001) effects. For each increase of 10 ml/min in CrCl (estimated either by the Cockcroft–Gault or by Modification of Diet in Renal Disease Study equations) a mean decrease in PRx of approximately 0.01 was expected. Amongst possible confounders only norepinephrine was shown to have a significant effect. Mean PRx value for outcome
fatal status
was greater than mean PRx for
nonfatal status
(
p
< 0.05), regardless of the model used for the CrCl estimation.
Conclusions
Better cerebral autoregulation evaluated with cerebrovascular PRx is significantly correlated with augmented renal clearance in TBI patients and associates with better outcome.</description><identifier>ISSN: 1541-6933</identifier><identifier>EISSN: 1556-0961</identifier><identifier>DOI: 10.1007/s12028-014-0045-1</identifier><identifier>PMID: 25273515</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Aged ; Brain Injuries - blood ; Brain Injuries - epidemiology ; Brain Injuries - physiopathology ; Cerebrovascular Circulation - physiology ; Comorbidity ; Creatinine ; Critical Care Medicine ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Glomerular Filtration Rate - physiology ; Humans ; Intensive ; Internal Medicine ; Kidney diseases ; Kidney Diseases - blood ; Kidney Diseases - diagnosis ; Kidney Diseases - epidemiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Neurology ; Original Article ; Patients ; Proteins ; Sodium ; Software ; Trauma ; Traumatic brain injury ; Ventilation ; Ventilators ; Young Adult</subject><ispartof>Neurocritical care, 2015-04, Vol.22 (2), p.192-201</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>Springer Science+Business Media New York 2014.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-e6151a89d6de1382c3ec33955286b4e327553e7a77225cd41fc4a8243848e2cb3</citedby><cites>FETCH-LOGICAL-c475t-e6151a89d6de1382c3ec33955286b4e327553e7a77225cd41fc4a8243848e2cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12028-014-0045-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2920706133?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21367,27901,27902,33721,33722,41464,42533,43781,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25273515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dias, Celeste</creatorcontrib><creatorcontrib>Gaio, A. Rita</creatorcontrib><creatorcontrib>Monteiro, Elisabete</creatorcontrib><creatorcontrib>Barbosa, Silvina</creatorcontrib><creatorcontrib>Cerejo, António</creatorcontrib><creatorcontrib>Donnelly, Joseph</creatorcontrib><creatorcontrib>Felgueiras, Óscar</creatorcontrib><creatorcontrib>Smielewski, Peter</creatorcontrib><creatorcontrib>Paiva, José-Artur</creatorcontrib><creatorcontrib>Czosnyka, Marek</creatorcontrib><title>Kidney-Brain Link in Traumatic Brain Injury Patients? A preliminary report</title><title>Neurocritical care</title><addtitle>Neurocrit Care</addtitle><addtitle>Neurocrit Care</addtitle><description>Background
Kidney hyperfiltration with augmented renal clearance is frequently observed in patients with traumatic brain injury. The aim of this study is to report preliminary findings about the relationship between brain autoregulation impairment, estimated kidney glomerular filtration rate and outcome in critically ill patients after severe traumatic brain injury.
Methods
Data collected from a cohort of 18 consecutive patients with severe traumatic brain injury managed with ICP monitoring in a Neurocritical Care Unit, were retrospectively analyzed. Early morning blood tests were performed for routine chemistry assessments and we analyzed creatinine and estimated creatinine clearance, osmolarity, and sodium. Daily norepinephrine dose, protein intake, and water balance were documented. Time average of brain monitoring data (intracranial pressure, cerebral perfusion pressure, and cerebrovascular reactivity pressure index—PRx) were calculated for 6 h before blood sample tests. Patient outcome was evaluated using Glasgow outcome scale at 6-month follow-up, considering non
fatal
outcome if GOS ≥3 and
fatal
outcome if GOS <3. Multiple linear regression models were used to study the crude and adjusted effects of the above variables on PRx throughout time.
Results
A total of 199 complete daily observations from 18 adult consecutive multiple trauma patients with severe traumatic brain injury were analyzed. At hospital admission, the median post-resuscitation Glasgow coma score was 6 (range 3–12), mean SAPSII score was 44.65 with predicted mortality of 36 %. Hospital mortality rate was 27 % and median GOS at 6 month after discharge was 3. Creatinine clearance (CrCl) was found to have a negative correlation with PRx (Pearson correlation—0.82), with statistically significant crude (
p
< 0.001) and adjusted (
p
= 0.001) effects. For each increase of 10 ml/min in CrCl (estimated either by the Cockcroft–Gault or by Modification of Diet in Renal Disease Study equations) a mean decrease in PRx of approximately 0.01 was expected. Amongst possible confounders only norepinephrine was shown to have a significant effect. Mean PRx value for outcome
fatal status
was greater than mean PRx for
nonfatal status
(
p
< 0.05), regardless of the model used for the CrCl estimation.
Conclusions
Better cerebral autoregulation evaluated with cerebrovascular PRx is significantly correlated with augmented renal clearance in TBI patients and associates with better outcome.</description><subject>Adult</subject><subject>Aged</subject><subject>Brain Injuries - blood</subject><subject>Brain Injuries - epidemiology</subject><subject>Brain Injuries - physiopathology</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Comorbidity</subject><subject>Creatinine</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Glasgow Outcome Scale</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Humans</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Kidney diseases</subject><subject>Kidney Diseases - blood</subject><subject>Kidney Diseases - diagnosis</subject><subject>Kidney Diseases - epidemiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Proteins</subject><subject>Sodium</subject><subject>Software</subject><subject>Trauma</subject><subject>Traumatic brain injury</subject><subject>Ventilation</subject><subject>Ventilators</subject><subject>Young Adult</subject><issn>1541-6933</issn><issn>1556-0961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU1rGzEQhkVJqJ20P6CXsJBLLko0-tw9Fce0-TKkB_csZO24rOvVutLuwf8-Mus2UAhElxHvPPMKzUvIF2DXwJi5ScAZLykDSRmTisIHMgWlNGWVhpPDXQLVlRATcpbShjFuKqM-kglX3AgFakoen5o64J7eRteEYtGE30Wuy-iG1vWNL0b9IWyGuC9-ZAlDn74Ws2IXcdu0TXBZj7jrYv-JnK7dNuHnYz0nP79_W87v6eL57mE-W1AvjeopalDgyqrWNYIouRfohaiU4qVeSRTcKCXQOGM4V76WsPbSlVyKUpbI_Uqck6vRdxe7PwOm3rZN8rjduoDdkCxoo4WspGLvQLXMRzGd0cv_0E03xJA_YnnFmWEahMgUjJSPXUoR13YXmzbvwAKzh0zsmInNmdhDJhbyzMXReVi1WP-b-BtCBvgIpNwKvzC-Pv226wtiX5OT</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Dias, Celeste</creator><creator>Gaio, A. Rita</creator><creator>Monteiro, Elisabete</creator><creator>Barbosa, Silvina</creator><creator>Cerejo, António</creator><creator>Donnelly, Joseph</creator><creator>Felgueiras, Óscar</creator><creator>Smielewski, Peter</creator><creator>Paiva, José-Artur</creator><creator>Czosnyka, Marek</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20150401</creationdate><title>Kidney-Brain Link in Traumatic Brain Injury Patients? A preliminary report</title><author>Dias, Celeste ; Gaio, A. Rita ; Monteiro, Elisabete ; Barbosa, Silvina ; Cerejo, António ; Donnelly, Joseph ; Felgueiras, Óscar ; Smielewski, Peter ; Paiva, José-Artur ; Czosnyka, Marek</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-e6151a89d6de1382c3ec33955286b4e327553e7a77225cd41fc4a8243848e2cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Brain Injuries - blood</topic><topic>Brain Injuries - epidemiology</topic><topic>Brain Injuries - physiopathology</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Comorbidity</topic><topic>Creatinine</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Glasgow Outcome Scale</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Humans</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Kidney diseases</topic><topic>Kidney Diseases - blood</topic><topic>Kidney Diseases - diagnosis</topic><topic>Kidney Diseases - epidemiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Proteins</topic><topic>Sodium</topic><topic>Software</topic><topic>Trauma</topic><topic>Traumatic brain injury</topic><topic>Ventilation</topic><topic>Ventilators</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dias, Celeste</creatorcontrib><creatorcontrib>Gaio, A. Rita</creatorcontrib><creatorcontrib>Monteiro, Elisabete</creatorcontrib><creatorcontrib>Barbosa, Silvina</creatorcontrib><creatorcontrib>Cerejo, António</creatorcontrib><creatorcontrib>Donnelly, Joseph</creatorcontrib><creatorcontrib>Felgueiras, Óscar</creatorcontrib><creatorcontrib>Smielewski, Peter</creatorcontrib><creatorcontrib>Paiva, José-Artur</creatorcontrib><creatorcontrib>Czosnyka, Marek</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Neurocritical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dias, Celeste</au><au>Gaio, A. Rita</au><au>Monteiro, Elisabete</au><au>Barbosa, Silvina</au><au>Cerejo, António</au><au>Donnelly, Joseph</au><au>Felgueiras, Óscar</au><au>Smielewski, Peter</au><au>Paiva, José-Artur</au><au>Czosnyka, Marek</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Kidney-Brain Link in Traumatic Brain Injury Patients? A preliminary report</atitle><jtitle>Neurocritical care</jtitle><stitle>Neurocrit Care</stitle><addtitle>Neurocrit Care</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>22</volume><issue>2</issue><spage>192</spage><epage>201</epage><pages>192-201</pages><issn>1541-6933</issn><eissn>1556-0961</eissn><abstract>Background
Kidney hyperfiltration with augmented renal clearance is frequently observed in patients with traumatic brain injury. The aim of this study is to report preliminary findings about the relationship between brain autoregulation impairment, estimated kidney glomerular filtration rate and outcome in critically ill patients after severe traumatic brain injury.
Methods
Data collected from a cohort of 18 consecutive patients with severe traumatic brain injury managed with ICP monitoring in a Neurocritical Care Unit, were retrospectively analyzed. Early morning blood tests were performed for routine chemistry assessments and we analyzed creatinine and estimated creatinine clearance, osmolarity, and sodium. Daily norepinephrine dose, protein intake, and water balance were documented. Time average of brain monitoring data (intracranial pressure, cerebral perfusion pressure, and cerebrovascular reactivity pressure index—PRx) were calculated for 6 h before blood sample tests. Patient outcome was evaluated using Glasgow outcome scale at 6-month follow-up, considering non
fatal
outcome if GOS ≥3 and
fatal
outcome if GOS <3. Multiple linear regression models were used to study the crude and adjusted effects of the above variables on PRx throughout time.
Results
A total of 199 complete daily observations from 18 adult consecutive multiple trauma patients with severe traumatic brain injury were analyzed. At hospital admission, the median post-resuscitation Glasgow coma score was 6 (range 3–12), mean SAPSII score was 44.65 with predicted mortality of 36 %. Hospital mortality rate was 27 % and median GOS at 6 month after discharge was 3. Creatinine clearance (CrCl) was found to have a negative correlation with PRx (Pearson correlation—0.82), with statistically significant crude (
p
< 0.001) and adjusted (
p
= 0.001) effects. For each increase of 10 ml/min in CrCl (estimated either by the Cockcroft–Gault or by Modification of Diet in Renal Disease Study equations) a mean decrease in PRx of approximately 0.01 was expected. Amongst possible confounders only norepinephrine was shown to have a significant effect. Mean PRx value for outcome
fatal status
was greater than mean PRx for
nonfatal status
(
p
< 0.05), regardless of the model used for the CrCl estimation.
Conclusions
Better cerebral autoregulation evaluated with cerebrovascular PRx is significantly correlated with augmented renal clearance in TBI patients and associates with better outcome.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>25273515</pmid><doi>10.1007/s12028-014-0045-1</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1541-6933 |
| ispartof | Neurocritical care, 2015-04, Vol.22 (2), p.192-201 |
| issn | 1541-6933 1556-0961 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1676349450 |
| source | MEDLINE; SpringerLink (Online service); ProQuest Central |
| subjects | Adult Aged Brain Injuries - blood Brain Injuries - epidemiology Brain Injuries - physiopathology Cerebrovascular Circulation - physiology Comorbidity Creatinine Critical Care Medicine Female Glasgow Coma Scale Glasgow Outcome Scale Glomerular Filtration Rate - physiology Humans Intensive Internal Medicine Kidney diseases Kidney Diseases - blood Kidney Diseases - diagnosis Kidney Diseases - epidemiology Male Medicine Medicine & Public Health Middle Aged Mortality Neurology Original Article Patients Proteins Sodium Software Trauma Traumatic brain injury Ventilation Ventilators Young Adult |
| title | Kidney-Brain Link in Traumatic Brain Injury Patients? A preliminary report |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T12%3A22%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Kidney-Brain%20Link%20in%20Traumatic%20Brain%20Injury%20Patients?%20A%20preliminary%20report&rft.jtitle=Neurocritical%20care&rft.au=Dias,%20Celeste&rft.date=2015-04-01&rft.volume=22&rft.issue=2&rft.spage=192&rft.epage=201&rft.pages=192-201&rft.issn=1541-6933&rft.eissn=1556-0961&rft_id=info:doi/10.1007/s12028-014-0045-1&rft_dat=%3Cproquest_cross%3E1664444506%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2920706133&rft_id=info:pmid/25273515&rfr_iscdi=true |