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Prostacyclin Infusion May Prevent Secondary Damage in Pericontusional Brain Tissue.

Reinstrup, Peter LU and Nordström, Carl-Henrik LU (2011) In Neurocritical Care 14. p.441-446
Abstract
BACKGROUND: Prostacyclin is a potent vasodilator, inhibitor of leukocyte adhesion, and platelet aggregation, and has been suggested as therapy for cerebral ischemia. A case of focal traumatic brain lesion that was monitored using intracerebral microdialysis, and bedside analysis and display is reported here. When biochemical signs of cerebral ischemia progressed, i.v. infusion of prostacyclin was started. METHODS: Two microdialysis catheters were placed in the penumbra zones surrounding evacuated focal brain contusions. The samples were analyzed for glucose, pyruvate, lactate, glutamate, and glycerol. RESULTS: When biochemical deterioration indicated progressive secondary ischemia (increase in lactate/pyruvate ratio, decrease in glucose,... (More)
BACKGROUND: Prostacyclin is a potent vasodilator, inhibitor of leukocyte adhesion, and platelet aggregation, and has been suggested as therapy for cerebral ischemia. A case of focal traumatic brain lesion that was monitored using intracerebral microdialysis, and bedside analysis and display is reported here. When biochemical signs of cerebral ischemia progressed, i.v. infusion of prostacyclin was started. METHODS: Two microdialysis catheters were placed in the penumbra zones surrounding evacuated focal brain contusions. The samples were analyzed for glucose, pyruvate, lactate, glutamate, and glycerol. RESULTS: When biochemical deterioration indicated progressive secondary ischemia (increase in lactate/pyruvate ratio, decrease in glucose, and increase in glutamate levels), continuous infusion of prostacyclin (0.5-1.0 ng kg(-1) min(-1) i.v.) was started. The treatment resulted in an improvement of the lactate/pyruvate ratios and a normalization of the interstitial levels of glucose and glutamate. The glycerol levels remained within normal limits indicating that degradation of cellular membranes had not occurred. CONCLUSION: The above case supports the view that new therapies directed toward protection of the sensitive biochemical penumbra zones surrounding focal brain lesions may be evaluated by intracerebral microdialysis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Neurocritical Care
volume
14
pages
441 - 446
publisher
Humana Press
external identifiers
  • wos:000290226800019
  • pmid:21161698
  • scopus:79955857292
ISSN
1541-6933
DOI
10.1007/s12028-010-9486-3
language
English
LU publication?
yes
id
b32d8e15-c600-44f0-aac9-e9f7241ec443 (old id 1756271)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21161698?dopt=Abstract
date added to LUP
2011-01-03 15:43:09
date last changed
2017-11-12 04:07:23
@article{b32d8e15-c600-44f0-aac9-e9f7241ec443,
  abstract     = {BACKGROUND: Prostacyclin is a potent vasodilator, inhibitor of leukocyte adhesion, and platelet aggregation, and has been suggested as therapy for cerebral ischemia. A case of focal traumatic brain lesion that was monitored using intracerebral microdialysis, and bedside analysis and display is reported here. When biochemical signs of cerebral ischemia progressed, i.v. infusion of prostacyclin was started. METHODS: Two microdialysis catheters were placed in the penumbra zones surrounding evacuated focal brain contusions. The samples were analyzed for glucose, pyruvate, lactate, glutamate, and glycerol. RESULTS: When biochemical deterioration indicated progressive secondary ischemia (increase in lactate/pyruvate ratio, decrease in glucose, and increase in glutamate levels), continuous infusion of prostacyclin (0.5-1.0 ng kg(-1) min(-1) i.v.) was started. The treatment resulted in an improvement of the lactate/pyruvate ratios and a normalization of the interstitial levels of glucose and glutamate. The glycerol levels remained within normal limits indicating that degradation of cellular membranes had not occurred. CONCLUSION: The above case supports the view that new therapies directed toward protection of the sensitive biochemical penumbra zones surrounding focal brain lesions may be evaluated by intracerebral microdialysis.},
  author       = {Reinstrup, Peter and Nordström, Carl-Henrik},
  issn         = {1541-6933},
  language     = {eng},
  pages        = {441--446},
  publisher    = {Humana Press},
  series       = {Neurocritical Care},
  title        = {Prostacyclin Infusion May Prevent Secondary Damage in Pericontusional Brain Tissue.},
  url          = {http://dx.doi.org/10.1007/s12028-010-9486-3},
  volume       = {14},
  year         = {2011},
}