Discuss how teamwork/collaboration observed in clinical impacted patient care.
Discuss how your observations will be incorporated into your practice.
thogenesis. Elevated TNF-a levels were observed in CSF and plasma of patients with TBI (41, 42). Taurine, through reducing TNF-a levels in different models of tissue damage has indicated anti-inflammatory effect (34, 37, 38, 40). In our study, Taurine inhibited TNF-a activity and prevented it’s further increase and this is consistent with Su Y et al. study (37). Among examined cytokines, IL-10 is an anti-inflammatory cytokine that has an important role in inflammation suppression and prevention of excessive immune response. Elevated IL-10 levels in CSF and serum of patients with excessive TBI have been reported (43). On the other hand, it has been indicated that elevated IL-10 production is related to the subsequent sepsis (44). Also, it has been reported that IL-10 concentration in CSF of patients who experience undesirable outcomes is higher (45) and it was consistent with a study on burn patients in 2015 (46). Taurine supplementation in our study reduced IL-10 serum levels. However, at the end of the study, the comparison of mean changes in IL-10 levels, showed no significant difference between the two groups which can be due to the small sample size. CRP is an acute-phase protein that at the time of tissue injury or inflammation is produced in the liver and can have pro-inflammatory effects and increases secondary brain damage. Hs-CRP due to the close relationship with inflammation and tissue damage is considered as clinical infection marker and acute inflammatory response (47). Similar to other studies (29, 46, 48), supplementation with taurine reduced serum levels of hs-CRP. However, this difference between the two groups was not significant but further reduction of hs-CRP in taurine group shows faster control of inflammation resulted from brain traumatic injury. It has been indicated that longer duration of mechanical ventilation and ICU support for critically-ill patients with sepsis is related to low levels of plasma taurine (49). On the other hand, in previous studies, low plasma taurine levels are reported in patients with trauma (22-25). The most commonly used clinical tool for severity of neurological injury in adults is Glasgow Coma Scale (50) that is due to it’s inter-observer reliability and predictive validity (51). In our study, GCS in the taurine group increased significantly that shows improvement of clinical condition. Acute Physiology and Chronic Health Evaluation II (APACHEII) Score is a tool to measure disease severity in patients hospitalized in ICU (52). High APACHEII score is related to the subsequent risk of many common diseases and hospital mortalities (53, 54). In our study, APACHEII score in the taurine group reduced significantly. SOFA score is an objective and simple score that allows the estimation>GET ANSWER