Serial Plasma Choline Measurements after Cardiac Arrest in Patients Undergoing Mild Therapeutic Hypothermia: A Prospective Observational Pilot Trial

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Serial Plasma Choline Measurements after Cardiac Arrest in Patients Undergoing Mild Therapeutic Hypothermia: A Prospective Observational Pilot Trial

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by Christian Storm , Oliver Danne , Per Magne Uel , Christoph Leithner , Dietrich Hasper , Tim Schroeder

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20	position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr - VW, Borum, et al. (Show Context) Citation Context ... outlined by the Amercian Society of Parenteral Nutrition but such recommendations are based on different patient groups and are currently not valid for other specific settings such as cardiac arrest.=-=[24,25]-=-. Conclusion Plasma free choline levels were elevated immediately after resuscitation and decreased significantly to subnormal levels within 48–72 hours in hypothermia treated patients after cardiac a...
13	A & Loffelholz K - Klein, Koppen - 1990 (Show Context) Citation Context ...ted to phospholipid metabolism and has been investigated as a marker for global tissue ischaemia.[1–4] There is evidence that phospholipase A2 releases choline during membrane breakdown after hypoxia.=-=[2]-=- The supplementation of citicoline as precursor of choline has been investagted as neuroprotective and neuro-regenerative treatment after ischemic stroke. A metaanalysis suggests a benefit but a recen...
8	Citicoline in the treatment of acute ischaemic stroke: an international, randomised, multicentre, placebo-controlled study (ICTUS trial). Lancet 380 - Dávalos, Alvarez-Sabín, et al. - 2012 (Show Context) Citation Context ...tagted as neuroprotective and neuro-regenerative treatment after ischemic stroke. A metaanalysis suggests a benefit but a recent clinical trial could not confirm a positive effect in stroke patients. =-=[5,6]-=- In patients after cardiac arrest, the whole brain has suffered from a relatively short time of ischemia as compared to ischemic stroke. Thus, neuroregenerative effects of choline could in principle b...
6	Citicoline: update on a promising and widely available agent for neuroprotection and neurorepair. Rev Neurol Dis - JL (Show Context) Citation Context ...tagted as neuroprotective and neuro-regenerative treatment after ischemic stroke. A metaanalysis suggests a benefit but a recent clinical trial could not confirm a positive effect in stroke patients. =-=[5,6]-=- In patients after cardiac arrest, the whole brain has suffered from a relatively short time of ischemia as compared to ischemic stroke. Thus, neuroregenerative effects of choline could in principle b...
6	Bleie O, et al. (2008) Divergent associations of plasma choline and betaine with components of metabolic syndrome in middle age and elderly men and women - SV, GS, et al. (Show Context) Citation Context ...d in principle be more pronounced in cardiac arrest patients as compared to ischemic stroke patients. Reference plasma free choline levels in healthy volunteers have been described in several studies.=-=[7,8]-=- The time course of plasma free choline levels in patients after cardiac arrest, however, has not been determined in detail yet. In this pilot trial, serial plasma free choline (PLCHO) levels in 20 pa...
5	EA (2003) Determination of choline, betaine, and dimethylglycine in plasma by a high-throughput method based on normal-phase chromatography-tandem mass spectrometry. Clin Chem 49: 286 - PI, PM, et al. (Show Context) Citation Context ...rst hours after return of spontaneous circulation (ROSC) during hypothermia treatment.[12] We used liquid chromatography-tandem mass spectrometry to determine the PLCHO levels as previously described.=-=[13]-=- The measurements were carried out at the laboratory of Bevital (www.bevital.no; Bergen, Norway). In six patients, plasma free choline levels were not determined at 30 and 90 minutes after ROSC, becau...
5	The citicoline brain injury treatment (COBRIT) trial: design and methods - Zafonte, WT, et al. - 2009 (Show Context) Citation Context ...ebo-controlled, multi-center trial, has investigated the effect of 90 days of citicoline treatment on functional outcome in patients with complicated mild, moderate, and severe traumatic brain injury.=-=[21]-=- Patients received placebo or citicoline 1000 mg twice a day, and the endpoint was a combination of different functional outcome tests. The published final results showed no improvement in functional ...
4	S-100B is superior to NSE, BDNF and GFAP in predicting outcome of resuscitation from cardiac arrest with hypothermia treatment. Resuscitation 82: 26–31 - Mortberg, Zetterberg, et al. - 2011
4	Forsback S, Gronroos T, Lehikoinen P, Kahkonen M, et al. (2000) Blood metabolism of [methyl-11C]choline; implications for in vivo imaging with positron emission tomography - Roivainen (Show Context) Citation Context ...e to choline’s short half-life of approximately 10–25 minutes, furthermore we expected major changes during the first hours after return of spontaneous circulation (ROSC) during hypothermia treatment.=-=[12]-=- We used liquid chromatography-tandem mass spectrometry to determine the PLCHO levels as previously described.[13] The measurements were carried out at the laboratory of Bevital (www.bevital.no; Berge...
3	Mockel M (2010) Choline in acute coronary syndrome: an emerging biomarker with implications for the integrated assessment of plaque vulnerability. Expert Rev Mol Diagn 10 - Danne (Show Context) Citation Context ...trolled, multi-center trial, did not find a benefit for choline substitution in patients with moderate-to-severe ischaemic stroke.[5] The pathophysiology of choline has been reviewed before in detail.=-=[16]-=- Secades et al. evaluated the effect of citicoline in patients with acute primary supratentorial hemispheric cerebral haemorrhage in a placebocontrolled trial revealing the safety of administered citi...
2	AF, Eyngorn I, Wijman CA (2011) Sedation confounds outcome prediction in cardiac arrest survivors treated with hypothermia. Neurocrit Care 15 - EA, Mlynash, et al.
2	Frei U, Mockel M (2007) Whole blood choline and plasma choline in acute coronary syndromes: prognostic and pathophysiological implications. Clin Chim Acta 383 - Danne, Lueders, et al.
2	Decreased serum choline concentrations in humans after surgery, childbirth, and traumatic head injury. Neurochem Res 23: 727–732 - IH, Ozyurt, et al. - 1998 (Show Context) Citation Context ...s the lowest value.[17] Ulus et al. showed a choline decrease to 7.160.9 mmol/L two days after surgery in patients undergoing major surgical intervention or childbirth and after traumatic head injury.=-=[18]-=-. Choline deficiency after cardiac arrest in the phase of the postresuscitation syndrome might be different. During the reperfusion syndrome after global hypoxia following cardiac arrest one can specu...
2	Citicoline in intracerebral haemorrhage: a double-blind, randomized, placebocontrolled, multi-centre pilot study. Cerebrovasc Dis 21: 380–385 - JJ, Alvarez-Sabin, et al. - 2006 (Show Context) Citation Context ...evaluated the effect of citicoline in patients with acute primary supratentorial hemispheric cerebral haemorrhage in a placebocontrolled trial revealing the safety of administered citicolin to humans.=-=[20]-=- The citicoline brain injury treatment (COBRIT) trial in patients with traumatic brain injury, a randomized, doubleblind, placebo-controlled, multi-center trial, has investigated the effect of 90 days...
1	Loffelholz K (2004) Release of choline in the isolated heart, an indicator of ischemic phospholipid degradation and its protection by ischemic preconditioning: no evidence for a role of phospholipase D. Life Sci 75: 1609 - Bruhl, Hafner (Show Context) Citation Context ...\| e76720 indicate a revelant potential of choline levels for outcome prediction. Previous trials described a release of choline from hypoxic tissue into the plasma and therefore elevated PLCHO levels.=-=[1,2]-=- The extent of choline release may reflect the severity of global tissue damage due to hypoxia. In our study most patients showed elevated PLCHO levels on admission after successful resuscitation. Pat...
1	Denz C, Janke C, Ellinger K, et al. (2003) Intestinal ischaemia during cardiac arrest and resuscitation: comparative analysis of extracellular metabolites by microdialysis. Resuscitation 58 - Korth, Krieter
1	Formation of unesterified choline by rat brain - SH - 1985
1	Zeisel SH - Savendahl, MH, et al. - 1997 (Show Context) Citation Context ...d in principle be more pronounced in cardiac arrest patients as compared to ischemic stroke patients. Reference plasma free choline levels in healthy volunteers have been described in several studies.=-=[7,8]-=- The time course of plasma free choline levels in patients after cardiac arrest, however, has not been determined in detail yet. In this pilot trial, serial plasma free choline (PLCHO) levels in 20 pa...
1	Binnekade JM, Verbaan BW, Zandbergen EG, Koelman JH, et al. (2012) Predictive value of neurological examination for early cortical responses to somatosensory evoked potentials in patients with postanoxic coma - Bouwes (Show Context) Citation Context ...PM, Leithner C, Hasper D, et al. (2013) Serial Plasma Choline Measurements after Cardiac Arrest in Patients Undergoing Mild Therapeutic Hypothermia: A Prospective Observational Pilot Trial. PLoS ONE 8=-=(9)-=-: e76720. doi:10.1371/journal.pone.0076720 Editor: Received June 9, 2013; Accepted August 27, 2013; Published September 30, 2013 Copyright: 2013 Storm et al. This is an open-access article distribut...
1	Nagamia SH, et al. (2009) Usefulness of elevations in serum choline and free F2)-isoprostane to predict 30day cardiovascular outcomes in patients with acute coronary syndrome - RM, CS, et al.
1	Ulus IH (2004) Declines in serum free and bound choline concentrations in humans after three different types of major surgery. Clin Chem Lab Med 42: 1390–1395 - YO, Uncu, et al. (Show Context) Citation Context ...e demand for choline and choline supply leading to an profound decrease of plasma choline at this time. A decrease of choline levels in acute disease, injury and surgery has been described previously.=-=[17]-=- Metabolic effects of the neurohumoral stress response have been suggested as a potential mechanism for this decline. Figure 3 shows that choline levels further decline as the patient is rewarmed afte...
1	Alkan T, Temel SG, Tureyen K, Tolunay S, et al. (2010) Effects of citicoline used alone and in combination with mild hypothermia on apoptosis induced by focal cerebral ischemia in rats - Sahin (Show Context) Citation Context ...a combination of choline (administered in a bound form such as citicoline) and hypothermia is more effective than citicoline used alone in ameliorating cerebral damage after transient focal ischaemia.=-=[19]-=- The approach of choline substitution has only been evaluated in clinical trials with focal ischaemia (intracranial haemorrhage and stroke) using citicoline which is a choline metabolite and a precurs...
1	Friedewald WT, et al. (2012) Effect of citicoline on functional and cognitive status among patients with traumatic brain injury: Citicoline Brain Injury Treatment Trial (COBRIT). JAMA 308 - RD, Bagiella, et al. - 1993 (Show Context) Citation Context ...ice a day, and the endpoint was a combination of different functional outcome tests. The published final results showed no improvement in functional and cognitive status between the randomized groups.=-=[22]-=- This negative results in patients after ischaemic stroke and traumatic brain injury underline the difficulty in comparing focal ischaemia with global hypoxia after cardiac arrest as stated before. Th...
1	SM (2012) Early second trimester maternal plasma choline and betaine are related to measures of early cognitive development in term infants. PLoS One 7: e43448 - BT, RA, et al. (Show Context) Citation Context ...this time. A possible choline deficiency during cell membrane regeneration and repair after cardiac arrest requires further investigation, as choline is essentially needed for cell membrane synthesis.=-=[18,21,23]-=- However low choline levels have been associated with impairments in cognitive development in other settings.[23] Supportive treatment of choline deficiency after cardiac arrest might be a novel appro...
1	The addition of choline to parenteral nutrition. Gastroenterology 137: S119–128. Plasma Choline after Cardiac Arrest - AL - 2009 (Show Context) Citation Context ... outlined by the Amercian Society of Parenteral Nutrition but such recommendations are based on different patient groups and are currently not valid for other specific settings such as cardiac arrest.=-=[24,25]-=-. Conclusion Plasma free choline levels were elevated immediately after resuscitation and decreased significantly to subnormal levels within 48–72 hours in hypothermia treated patients after cardiac a...