THE SIGNIFICANCE OF ΝО GAS TRANSMITTER AND NUCLEASES IN SHAPING THE SEQUELAE OF TRAUMATIC BRAIN INJURY

Abstract

Traumatic brain injuries are at present remaining an important worldwide medical problem due to substantial percentages of incapacitation and lethality, especially among people of working age. All therapeutic interventions in TBI and their timeliness and efficacy depend on timely and quality diagnosis of patient’s condition, including laboratory parameters of blood and urine. The aim: To assess for peculiar patterns in changes of NO gas transmitter levels in patients with severe traumatic brain injury during the treatment period and to investigate into its relationship with nuclease enzymes in the context of various treatment outcomes. This research work has used clinical data, history and diagnostic tests obtained in 72 patients with severe traumatic brain injury, age 18 to 76 years (mean age 42.26±15.02 years), who six months later have been divided into the following four groups according to Glasgow outcome scale: “Death”, “Severe disability”, “Moderate disability” and “Recovery”. Biochemical assessments in patients with severe traumatic brain injury have shown supranormal levels of urinary nitric oxide and serum DNAses. Going forward, nitric oxide levels significantly decreased over the time of treatment in subjects with favorable outcomes (“Moderate disability” and “Recovery” groups) and increased with treatment time in subjects with unfavorable outcomes (“Severe disability” and “Death” groups). The diagnostic markers of further unfavorable survival outcomes may be present at the onset of treatment (Day 1) and may include urinary levels of nitric oxide below 1.1 μmol/L and DNAse levels below 26 μU/mL. A positive diagnostic sign of favorable survival and health outcomes may include DNAse І levels over 30.0 μU/mL from Day 7 of treatment. The findings of this work can be used when making a diagnosis/selecting an optimal treatment schedule and predicting the sequelae of traumatic brain injury in a patient, which may cumulatively minimize the impact of the injury.