Changes and effects of plasma arginine vasopressin in traumatic brain injury

Abstract

Background: Traumatic brain injury (TBI) is a common disease accompanied by chronic morbidity and mortality. The pathological mechanism and effective pharmacological treatments of TBI remain undetermined. It is suggested that AVP is involved in TBI. It is thus interesting to investigate the changes and effects of plasma AVP in clinical trials.

Methods: The serum concentrations of AVP, serum electrolytes, and serum osmolarity in a total of 23 TBI patients were dynamically monitored (on admission, Day 1, Day 3, and Day 5). Relationship between AVP and severity of brain injury and functional outcome were evaluated, respectively.

Results: The mean AVP serum concentrations in the TBI group were significantly higher than those recorded in the control (CTRL) group on intensive care unit (ICU) admission and Day 1 (p<0.05). On Day 3 and Day 5, the differences between those groups were not significant (p>0.05). The negative correlations were found between sodium and AVP (r=-0.35; p<0.05) and between osmolarity and AVP (r=-0.42; p<0.05). In poor outcome group, the mean AVP serum concentrations were significantly higher than in good outcome group and CTRL group (p<0.05). A statistically significant correlation was also found between AVP on ICU admission and the initial Glasgow Coma Scale (r=0.47; p<0.05).

Conclusion: We suggest that AVP is involved in the pathophysiology process of secondary brain damage after TBI. It seems that AVP antagonist is a promising target for the treatment of TBI, while further studies should be carried out.