Free Fatty Acids and Delayed Cerebral Ischemia After Subarachnoid Hemorrhage
- 1 March 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 43 (3), 691-696
- https://doi.org/10.1161/STROKEAHA.111.636035
Abstract
The purpose of this study was to understand factors related to increases in serum free fatty acid (FFA) levels and association with delayed cerebral ischemia (DCI) after subarachnoid hemorrhage. We performed serial measurement of systemic oxygen consumption by indirect calorimetry and FFA levels by liquid chromatography/mass spectrometry in the first 14 days after ictus in 50 consecutive patients with subarachnoid hemorrhage. Multivariable generalized estimating equation models identified associations with FFA levels in the first 14 days after SAH and Cox proportional hazards model used to identified associations with time to DCI. There were 187 measurements in 50 patients with subarachnoid hemorrhage (mean age, 56±14 years old; 66% women) with a median Hunt–Hess score of 3. Adjusting for Hunt–Hess grade and daily caloric intake, n-6 and n-3 FFA levels were both associated with oxygen consumption and the modified Fisher score. Fourteen (28%) patients developed DCI on median postbleed Day 7. The modified Fisher score ( P =0.01), mean n-6:n-3 FFA ratio ( P =0.02), and mean oxygen consumption level ( P =0.04) were higher in patients who developed DCI. In a Cox proportional hazards model, the mean n-6:n-3 FFA ratio ( P P =0.05), and modified Fisher scale ( P =0.004) were associated with time to DCI. Injury severity and oxygen consumption hypermetabolism are associated with higher n-FFA levels and an increased n-6:n-3 FFA ratio is associated with DCI. This may indicate a role for interventions that modulate both oxygen consumption and FFA levels to reduce the occurrence of DCI.This publication has 22 references indexed in Scilit:
- Relationship Between C-Reactive Protein, Systemic Oxygen Consumption, and Delayed Cerebral Ischemia After Aneurysmal Subarachnoid HemorrhageStroke, 2011
- Defining Vasospasm After Subarachnoid HemorrhageStroke, 2009
- DHA Supplementation Decreases Serum C-Reactive Protein and Other Markers of Inflammation in Hypertriglyceridemic MenJournal of Nutrition, 2009
- Metabolic Impact of Shivering During Therapeutic Temperature ModulationStroke, 2008
- Frequency and clinical impact of asymptomatic cerebral infarction due to vasospasm after subarachnoid hemorrhageJournal of Neurosurgery, 2008
- The Use of an Inflammation‐Modulating Diet in Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome: A Meta‐Analysis of Outcome DataJournal of Parenteral and Enteral Nutrition, 2008
- ω‐3 Fatty Acids–Supplemented Parenteral Nutrition Decreases Hyperinflammatory Response and Attenuates Systemic Disease Sequelae in Severe Acute Pancreatitis: A Randomized and Controlled StudyJournal of Parenteral and Enteral Nutrition, 2008
- IMPACT OF NOSOCOMIAL INFECTIOUS COMPLICATIONS AFTER SUBARACHNOID HEMORRHAGENeurosurgery, 2008
- Effect of Cisternal and Ventricular Blood on Risk of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage:Stroke, 2001
- Effects of Tirilazad Mesylate on Vasospasm and Phospholipid Hydroperoxides in a Primate Model of Subarachnoid HemorrhageStroke, 1999