| Extracellular lactate/pyruvate and glutamate changes in patients during per-operative episodes of cerebral ischaemia. | |
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MedLine Citation:
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PMID: 12168348 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Temporary Internal Carotid Artery (ICA) clipping necessary during aneurysm surgery was used as a model to investigate metabolic changes in the human brain during defined episodes of ischaemia. DESIGN: An observational study using intracerebral monitors: PBO2 (Neurotrend) and microdialysis (CMA, Sweden). SUBJECTS: 16 patients monitored during complex aneurysm surgery. OUTCOME MEASURES: Changes in extracellular concentrations of glucose, lactate, and glutamate and lactate/pyruvate ratio (L/P). RESULTS: Mean age was 55. 10 patients presented with subarachnoid haemorrhage and 6 with mass effect (4 giant). Temporary ICA occlusion was required for dissection (n = 9), intraoperative rupture (n = 5) or aneurysmal thrombectomy (n = 2). The mean total duration was 15 minutes (range 4-52 minutes). No infarcts developed in the monitored regions. Microdialysis was unsuccessful in 3 patients and Neurotrend in 1. Patients were grouped according to the degree and duration of fall in PBO2: minimal brief falls were not associated with microdialysis changes (n = 5). More pronounced falls were associated with increases in L/P (n = 4). Only prolonged occlusions averaging 42 minutes (n = 3) with PBO2 sustained below 1 kPa were associated with rises in glutamate. CONCLUSIONS: Brief temporary ICA occlusion caused an initial increased L/P. Glutamate increases were only seen after occlusion that was prolonged with PBO2 below 1.0 kPa. |
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Authors:
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R Kett-White; P J A Hutchinson; P G al-Rawi; A K Gupta; M T O'Connell; J D Pickard; P J Kirkpatrick |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta neurochirurgica. Supplement Volume: 81 ISSN: 0065-1419 ISO Abbreviation: Acta Neurochir. Suppl. Publication Date: 2002 |
Date Detail:
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Created Date: 2002-08-09 Completed Date: 2003-01-21 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 100962752 Medline TA: Acta Neurochir Suppl Country: Austria |
Other Details:
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Languages: eng Pagination: 363-5 Citation Subset: IM |
Affiliation:
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Academic Department of Neurosurgery, Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Biological Markers Brain / metabolism* Brain Ischemia / etiology, metabolism* Carotid Artery, Internal / surgery* Craniotomy Glutamic Acid / metabolism* Humans Intracranial Aneurysm / surgery* Lactic Acid / metabolism* Middle Aged Monitoring, Intraoperative / methods Neurosurgical Procedures / methods Pyruvic Acid / metabolism* Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 127-17-3/Pyruvic Acid; 50-21-5/Lactic Acid; 56-86-0/Glutamic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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