Document Detail

Posttraumatic brain vulnerability to hypoxia-hypotension: the importance of the delay between brain trauma and secondary insult.
MedLine Citation:
PMID:  17938889     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine whether the effect of hypoxia-hypotension (HH) after traumatic brain injury (TBI) is affected by the delay between insults. DESIGN: Thirty Sprague-Dawley rats were randomized into five groups: sham, TBI alone (trauma alone, impact-acceleration, 450 g weight drop from 1.8 m), HH alone (blood depletion, mean arterial pressure 40 mmHg, FIO2=10%, 15 min), TBI+early HH (TBI followed by HH, 45-min delay), and TBI+late HH (225-min delay). Cerebral perfusion pressure was continuously recorded. Brain microdialysis and PtiO2 probes were inserted stereotaxically into the right thalamus. MEASUREMENTS AND RESULTS: After the HH period and for 60 min a significant increase in cerebral lactate-pyruvate ratio was observed in groups subjected to HH vs. TBI alone and sham groups (33.0+/-5.1 for HH alone and 51.9+/-6.7 for TBI+early HH vs. 16.7+/-2.4 for TBI alone at the same time, 27.6+/-4.4 for TBI+late HH vs. 13.1+/-1 for TBI alone at the same time). There was no significant difference in lactate-pyruvate ratio peaks between HH alone and TBI+late HH while it was higher in TBI+early HH. Similar results were obtained for cerebral glycerol. PtiO2 during HH phase did not differ between HH alone, TBI+early HH and TBI+late HH (respectively, 4.2+/-3.1, 4.9+/-5.7, and 2.9+/-1.8 mmHg). CONCLUSIONS: A 45-min delay between HH and TBI has important metabolic consequences while a 225-min delay has a similar effect as HH in a noninjured brain. The posttraumatic brain vulnerability to HH depends on the delay between cerebral aggressions.
Thomas Geeraerts; Arnaud Friggeri; Jean-Xavier Mazoit; Dan Benhamou; Jacques Duranteau; Bernard Vigué
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-10-16
Journal Detail:
Title:  Intensive care medicine     Volume:  34     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-15     Completed Date:  2008-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  551-60     Citation Subset:  IM    
Département d'Anesthésie-Réanimation, Hôpital Bicêtre, AP-HP, 94276 Le Kremlin-Bicêtre, France.
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MeSH Terms
Brain / blood supply,  metabolism
Brain Edema / etiology,  metabolism,  physiopathology
Brain Injuries / complications*,  metabolism,  physiopathology,  therapy
Cerebrovascular Circulation
Disease Models, Animal
Glucose / metabolism
Glycerol / metabolism
Hypoxia, Brain / etiology*,  metabolism
Intracranial Hypotension / etiology*,  metabolism
Lactic Acid / metabolism
Oxygen / blood,  metabolism
Pyruvic Acid / metabolism
Rats, Sprague-Dawley
Time Factors
Reg. No./Substance:
127-17-3/Pyruvic Acid; 50-21-5/Lactic Acid; 50-99-7/Glucose; 56-81-5/Glycerol; 7782-44-7/Oxygen
Comment In:
Intensive Care Med. 2008 Mar;34(3):402-4   [PMID:  17938886 ]

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