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Bedside Evaluation of Cerebral Energy Metabolism in Severe Community-Acquired Bacterial Meningitis

Poulsen, Frantz R.; Schulz, Mette; Jacobsen, Anne; Andersen, Ase B.; Larsen, Lykke; Schalén, Wilhelm LU ; Nielsen, Troels H. and Nordstrom, Carl-Henrik (2015) In Neurocritical Care 22(2). p.221-228
Abstract
Mortality and morbidity have remained high in bacterial meningitis. Impairment of cerebral energy metabolism probably contributes to unfavorable outcome. Intracerebral microdialysis is routinely used to monitor cerebral energy metabolism, and recent experimental studies indicate that this technique may separate ischemia and non-ischemic mitochondrial dysfunction. The present study is a retrospective interpretation of biochemical data obtained in a series of patients with severe community-acquired meningitis. Cerebral energy metabolism was monitored in 15 patients with severe community-acquired meningitis utilizing intracerebral microdialysis and bedside biochemical analysis. According to previous studies, cerebral ischemia was defined as... (More)
Mortality and morbidity have remained high in bacterial meningitis. Impairment of cerebral energy metabolism probably contributes to unfavorable outcome. Intracerebral microdialysis is routinely used to monitor cerebral energy metabolism, and recent experimental studies indicate that this technique may separate ischemia and non-ischemic mitochondrial dysfunction. The present study is a retrospective interpretation of biochemical data obtained in a series of patients with severe community-acquired meningitis. Cerebral energy metabolism was monitored in 15 patients with severe community-acquired meningitis utilizing intracerebral microdialysis and bedside biochemical analysis. According to previous studies, cerebral ischemia was defined as lactate/pyruvate (LP) ratio > 30 with intracerebral pyruvate level < 70 A mu mol L-1. Non-ischemic mitochondrial dysfunction was defined as LP-ratio > 30 at a normal or increased interstitial concentration of pyruvate (a parts per thousand yen70 mu mol L-1). Patients with LP-ratios < 30 were classified as no mitochondrial dysfunction. The biochemical pattern was in 8 patients (10 microdialysis catheters) classified as no mitochondrial dysfunction, in 5 patients classified as non-ischemic mitochondrial dysfunction, and in 2 patients (3 catheters) classified as ischemia. In patients with severe community-acquired meningitis, compromised cerebral energy metabolism occurs frequently and was diagnosed in 7 out of 15 cases. A biochemical pattern of non-ischemic mitochondrial dysfunction appears to be a more common underlying condition than cerebral ischemia. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bacterial meningitis, Microdialysis, Ischemia, Mitochondrial, dysfunction, Lactate, Pyruvate
in
Neurocritical Care
volume
22
issue
2
pages
221 - 228
publisher
Humana Press
external identifiers
  • wos:000351447100007
  • scopus:84924987533
ISSN
1541-6933
DOI
10.1007/s12028-014-0057-x
language
English
LU publication?
yes
id
1852b44c-30d9-4ce9-b201-538f3b21db29 (old id 5277837)
date added to LUP
2015-05-04 08:57:02
date last changed
2017-03-12 03:10:22
@article{1852b44c-30d9-4ce9-b201-538f3b21db29,
  abstract     = {Mortality and morbidity have remained high in bacterial meningitis. Impairment of cerebral energy metabolism probably contributes to unfavorable outcome. Intracerebral microdialysis is routinely used to monitor cerebral energy metabolism, and recent experimental studies indicate that this technique may separate ischemia and non-ischemic mitochondrial dysfunction. The present study is a retrospective interpretation of biochemical data obtained in a series of patients with severe community-acquired meningitis. Cerebral energy metabolism was monitored in 15 patients with severe community-acquired meningitis utilizing intracerebral microdialysis and bedside biochemical analysis. According to previous studies, cerebral ischemia was defined as lactate/pyruvate (LP) ratio &gt; 30 with intracerebral pyruvate level &lt; 70 A mu mol L-1. Non-ischemic mitochondrial dysfunction was defined as LP-ratio &gt; 30 at a normal or increased interstitial concentration of pyruvate (a parts per thousand yen70 mu mol L-1). Patients with LP-ratios &lt; 30 were classified as no mitochondrial dysfunction. The biochemical pattern was in 8 patients (10 microdialysis catheters) classified as no mitochondrial dysfunction, in 5 patients classified as non-ischemic mitochondrial dysfunction, and in 2 patients (3 catheters) classified as ischemia. In patients with severe community-acquired meningitis, compromised cerebral energy metabolism occurs frequently and was diagnosed in 7 out of 15 cases. A biochemical pattern of non-ischemic mitochondrial dysfunction appears to be a more common underlying condition than cerebral ischemia.},
  author       = {Poulsen, Frantz R. and Schulz, Mette and Jacobsen, Anne and Andersen, Ase B. and Larsen, Lykke and Schalén, Wilhelm and Nielsen, Troels H. and Nordstrom, Carl-Henrik},
  issn         = {1541-6933},
  keyword      = {Bacterial meningitis,Microdialysis,Ischemia,Mitochondrial,dysfunction,Lactate,Pyruvate},
  language     = {eng},
  number       = {2},
  pages        = {221--228},
  publisher    = {Humana Press},
  series       = {Neurocritical Care},
  title        = {Bedside Evaluation of Cerebral Energy Metabolism in Severe Community-Acquired Bacterial Meningitis},
  url          = {http://dx.doi.org/10.1007/s12028-014-0057-x},
  volume       = {22},
  year         = {2015},
}