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.
(Less)
- author
- Cesarini, K G
; Enblad, P
; Ronne-Engström, E
; Marklund, N
LU
; Salci, K
; Nilsson, P
; Hårdemark, H-G
; Hillered, L
and Persson, L
- publishing date
- 2002-11
- 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},
}