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Early cerebral hyperglycolysis after subarachnoid haemorrhage correlates with favourable outcome

Cesarini, K G ; Enblad, P ; Ronne-Engström, E ; Marklund, N LU ; Salci, K ; Nilsson, P ; Hårdemark, H-G ; Hillered, L and Persson, L (2002) In Acta Neurochirurgica 144(11). p.31-1121
Abstract

BACKGROUND: Intracerebral microdialysis (MD) was applied in patients with severe subarachnoid haemorrhage treated in a neurosurgical intensive care unit in order to explore their cerebral energy metabolism.

METHOD: Brain MD fluid levels of glucose, lactate and pyruvate were measured for 3 to 12 days in 20 patients and 2,635 hourly samples were analysed. The MD data were related to computerized tomography and clinical outcome, assessed by the Glasgow Outcome Scale.

FINDINGS: The study showed that most patients who made a good recovery had a specific curve pattern when plotting the studied metabolites over time, characterised by a distinct decrease in MD-glucose and a parallel increase in both MD-lactate and pyruvate. Patients... (More)

BACKGROUND: Intracerebral microdialysis (MD) was applied in patients with severe subarachnoid haemorrhage treated in a neurosurgical intensive care unit in order to explore their cerebral energy metabolism.

METHOD: Brain MD fluid levels of glucose, lactate and pyruvate were measured for 3 to 12 days in 20 patients and 2,635 hourly samples were analysed. The MD data were related to computerized tomography and clinical outcome, assessed by the Glasgow Outcome Scale.

FINDINGS: The study showed that most patients who made a good recovery had a specific curve pattern when plotting the studied metabolites over time, characterised by a distinct decrease in MD-glucose and a parallel increase in both MD-lactate and pyruvate. Patients who had an unfavourable outcome lacked this distinct curve pattern and exhibited more irregular changes, including increased levels of both MD-glucose and lactate and low MD-pyruvate levels.

INTERPRETATION: This exploratory study suggests that accumulation of interstitial lactate and pyruvate, together with decreasing levels of glucose is a favourable prognostic pattern presumably reflecting increased glucose metabolism. Such hyperglycolysis may be elicited in patients with recovery potential to cope with an extreme metabolic demand set in motion by a brain insult to restore brain cell homeostasis and integrity.

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publishing date
type
Contribution to journal
publication status
published
keywords
Adolescent, Adult, Aged, Blood Glucose, Brain, Embolization, Therapeutic, Energy Metabolism, Female, Glasgow Outcome Scale, Glycolysis, Humans, Intracranial Aneurysm, Lactic Acid, Male, Microdialysis, Microsurgery, Middle Aged, Prognosis, Pyruvic Acid, Subarachnoid Hemorrhage, Survival Rate
in
Acta Neurochirurgica
volume
144
issue
11
pages
11 pages
publisher
Springer
external identifiers
  • pmid:12434168
  • scopus:0036433025
ISSN
0001-6268
DOI
10.1007/s00701-002-1011-9
language
English
LU publication?
no
id
fb9c6885-cc27-4b86-b04b-1ff6af13488a
date added to LUP
2018-03-01 11:38:49
date last changed
2021-01-06 08:01:12
@article{fb9c6885-cc27-4b86-b04b-1ff6af13488a,
  abstract     = {<p>BACKGROUND: Intracerebral microdialysis (MD) was applied in patients with severe subarachnoid haemorrhage treated in a neurosurgical intensive care unit in order to explore their cerebral energy metabolism.</p><p>METHOD: Brain MD fluid levels of glucose, lactate and pyruvate were measured for 3 to 12 days in 20 patients and 2,635 hourly samples were analysed. The MD data were related to computerized tomography and clinical outcome, assessed by the Glasgow Outcome Scale.</p><p>FINDINGS: The study showed that most patients who made a good recovery had a specific curve pattern when plotting the studied metabolites over time, characterised by a distinct decrease in MD-glucose and a parallel increase in both MD-lactate and pyruvate. Patients who had an unfavourable outcome lacked this distinct curve pattern and exhibited more irregular changes, including increased levels of both MD-glucose and lactate and low MD-pyruvate levels.</p><p>INTERPRETATION: This exploratory study suggests that accumulation of interstitial lactate and pyruvate, together with decreasing levels of glucose is a favourable prognostic pattern presumably reflecting increased glucose metabolism. Such hyperglycolysis may be elicited in patients with recovery potential to cope with an extreme metabolic demand set in motion by a brain insult to restore brain cell homeostasis and integrity.</p>},
  author       = {Cesarini, K G and Enblad, P and Ronne-Engström, E and Marklund, N and Salci, K and Nilsson, P and Hårdemark, H-G and Hillered, L and Persson, L},
  issn         = {0001-6268},
  language     = {eng},
  number       = {11},
  pages        = {31--1121},
  publisher    = {Springer},
  series       = {Acta Neurochirurgica},
  title        = {Early cerebral hyperglycolysis after subarachnoid haemorrhage correlates with favourable outcome},
  url          = {http://dx.doi.org/10.1007/s00701-002-1011-9},
  doi          = {10.1007/s00701-002-1011-9},
  volume       = {144},
  year         = {2002},
}