Document Detail

Brain metabolism during a decrease in cerebral perfusion pressure caused by an elevated intracranial pressure in the porcine neocortex.
MedLine Citation:
PMID:  17717234     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cranial hypertension coincides with a reduction in cerebral blood flow as well as in oxygen delivery and influences outcome. In this study, we monitored changes in energy-related metabolites in the porcine cortex during an increase of intracranial pressure (ICP) and to determine the level at which damage occurs. METHODS: Male domestic pigs (32-40 kg) were anesthetized, mechanically ventilated, and randomly assigned to either the experimental (n = 6) or control groups (n = 5). A microdialysis probe (CMA 70) was inserted into the cortex to measure extracellular dialysate concentrations of lactate, pyruvate, glucose, glutamate, and glycerol. Every hour an increase of 10 mm Hg in ICP was preformed in the experimental group by infusion of artificial cerebrospinal fluid into the ventricular system of the brain until a maximum ICP of 50 mm Hg was reached. RESULTS: We demonstrated a significant increase of lactate and glycerol compared with control at ICP values > or =30 mm Hg and cerebral perfusion pressure (CPP) below 50 mm Hg. The increase of ICP to > or =40 mm Hg in conjunction with a reduction in CPP below 40 mm Hg led to a significant increase in the lactate/pyruvate-ratio and glutamate, as well as a decrease of glucose in relation to control. CONCLUSIONS: Our data strongly suggest that, during a defined ICP increase, lower CPP values may be tolerable until severe damage occurs. Borderline ICP and CPP values of 30 and 40 mm Hg, respectively, could be advised.
Norbert Zoremba; Joerg Schnoor; Michael Berens; Ralf Kuhlen; Rolf Rossaint
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  105     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-24     Completed Date:  2007-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  744-50     Citation Subset:  AIM; IM    
Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany.
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MeSH Terms
Brain Ischemia / etiology*,  metabolism,  physiopathology
Cerebrovascular Circulation*
Disease Models, Animal
Glucose / metabolism
Glutamic Acid / metabolism
Glycerol / metabolism
Intracranial Hypertension / complications,  metabolism*,  physiopathology
Intracranial Pressure*
Lactic Acid / metabolism
Neocortex / blood supply,  metabolism*
Pyruvic Acid / metabolism
Sus scrofa
Time Factors
Reg. No./Substance:
127-17-3/Pyruvic Acid; 50-21-5/Lactic Acid; 50-99-7/Glucose; 56-81-5/Glycerol; 56-86-0/Glutamic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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