Chapter title |
Extracellular lactate/pyruvate and glutamate changes in patients during per-operative episodes of cerebral ischaemia.
|
---|---|
Chapter number | 92 |
Book title |
Intracranial Pressure and Brain Biochemical Monitoring
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Published in |
Acta neurochirurgica Supplement, January 2002
|
DOI | 10.1007/978-3-7091-6738-0_92 |
Pubmed ID | |
Book ISBNs |
978-3-70-917397-8, 978-3-70-916738-0
|
Authors |
Kett-White, R, Hutchinson, P J A, al-Rawi, P G, Gupta, A K, O'Connell, M T, Pickard, J D, Kirkpatrick, P J, R. Kett-White, P. J. A. Hutchinson, P. G. Al-Rawi, A. K. Gupta, M. T. O’Connell, J. D. Pickard, P. J. Kirkpatrick, Kett-White, R., Hutchinson, P. J. A., Al-Rawi, P. G., Gupta, A. K., O’Connell, M. T., Pickard, J. D., Kirkpatrick, P. J. |
Abstract |
Temporary Internal Carotid Artery (ICA) clipping necessary during aneurysm surgery was used as a model to investigate metabolic changes in the human brain during defined episodes of ischaemia. An observational study using intracerebral monitors: PBO2 (Neurotrend) and microdialysis (CMA, Sweden). 16 patients monitored during complex aneurysm surgery. Changes in extracellular concentrations of glucose, lactate, and glutamate and lactate/pyruvate ratio (L/P). Mean age was 55. 10 patients presented with subarachnoid haemorrhage and 6 with mass effect (4 giant). Temporary ICA occlusion was required for dissection (n = 9), intraoperative rupture (n = 5) or aneurysmal thrombectomy (n = 2). The mean total duration was 15 minutes (range 4-52 minutes). No infarcts developed in the monitored regions. Microdialysis was unsuccessful in 3 patients and Neurotrend in 1. Patients were grouped according to the degree and duration of fall in PBO2: minimal brief falls were not associated with microdialysis changes (n = 5). More pronounced falls were associated with increases in L/P (n = 4). Only prolonged occlusions averaging 42 minutes (n = 3) with PBO2 sustained below 1 kPa were associated with rises in glutamate. Brief temporary ICA occlusion caused an initial increased L/P. Glutamate increases were only seen after occlusion that was prolonged with PBO2 below 1.0 kPa. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 4% |
Unknown | 22 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 6 | 26% |
Student > Doctoral Student | 4 | 17% |
Student > Master | 3 | 13% |
Student > Ph. D. Student | 2 | 9% |
Professor > Associate Professor | 2 | 9% |
Other | 2 | 9% |
Unknown | 4 | 17% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 13 | 57% |
Neuroscience | 3 | 13% |
Agricultural and Biological Sciences | 1 | 4% |
Unknown | 6 | 26% |