[Epinephrine and norepinephrine release immediately following acute cranio-cerebral trauma and the resulting...

Severe head injury leads to typical cardiocirculatory and metabolic changes by massive release of catecholamines. However, in the literature no data on these disturbances are available in humans in the preclinical phase. Therefore we measured in 34 head injured patients at the site of the accident and after hospital admission the degree of unconsciousness (Glasgow-Coma-Scale), blood pressure, heart rate, catecholamines, free fatty acids, electrolytes, lactate and blood sugar. Immediately after trauma a close correlation was found between the Glasgow-Coma-Score and the levels of adrenaline and noradrenaline, respectively (R = 0.64; R = 59). A closer relationship was found between Glasgow-Coma-Scale and the extent of hypopotassemia. However, no correlation existed between the degree of loss of consciousness and haemodynamic parameters, electrolytes, blood sugar and lactate. On hospital admission the extent of hypopotassemia showed a close relationship to the degree of excreted catecholamines at the site of accident. Patients intubated and ventilated at the scene showed remarkably lower catecholamine levels at the time of admission.