Document Detail

Brain lactate by magnetic resonance spectroscopy during fulminant hepatic failure in the dog.
MedLine Citation:
PMID:  9516569     Owner:  NLM     Status:  MEDLINE    
A noninvasive test is needed to assess the severity of encephalopathy during fulminant hepatic failure. This feasibility study was designed to compare a noninvasive test, brain lactate measurement by magnetic resonance spectroscopy, with intracranial pressure monitoring in a large animal model of fulminant hepatic failure. Five dogs received an intraventricular catheter for intracranial pressure measurement. Liver injury was induced by intravenous bolus of D-galactosamine. Brain lactate concentrations were determined by magnetic resonance spectroscopy for up to 48 hours after D-galactosamine administration (t = 0 hour). A dose of D-galactosamine exceeding 1.5 g/kg resulted in fulminant hepatic failure. Brain lactate levels increased to > 10 mmol/L in the two dogs that developed severe intracranial hypertension of > 50 mm Hg and sustained cerebral perfusion pressures of < 40 mm Hg. Both dogs experienced brain death, 42 and 48 hours after the administration of D-galactosamine. Brain lactate concentrations determined by magnetic resonance spectroscopy were in agreement with brain tissue concentrations of lactate determined by high-performance liquid chromatography at necropsy. Plasma lactate concentrations were only mildly elevated (3.2 and 4.2 mmol/L) at the time of brain death. Elevated levels of brain lactate are associated with intracranial hypertension and poor neurological outcome during fulminant hepatic failure.
S L Nyberg; F B Cerra; R Gruetter
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Liver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  4     ISSN:  1074-3022     ISO Abbreviation:  Liver Transpl Surg     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-05-28     Completed Date:  1998-05-28     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9502504     Medline TA:  Liver Transpl Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  158-65     Citation Subset:  IM    
Department of Surgery, Mayo Medical Center, Rochester, MN 55905, USA.
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MeSH Terms
Biological Markers / analysis
Brain / metabolism*
Dose-Response Relationship, Drug
Feasibility Studies
Galactosamine / pharmacology
Glutamic Acid / metabolism
Glutamine / metabolism
Hepatic Encephalopathy / chemically induced,  metabolism*,  pathology,  physiopathology
Intracranial Hypertension / physiopathology*
Lactic Acid / blood,  metabolism*
Magnetic Resonance Spectroscopy
Time Factors
Grant Support
Reg. No./Substance:
0/Biological Markers; 50-21-5/Lactic Acid; 56-85-9/Glutamine; 56-86-0/Glutamic Acid; 7535-00-4/Galactosamine

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