000198345 001__ 198345
000198345 005__ 20181228151109.0
000198345 0247_ $$2doi$$a10.1007/s00134-013-3203-6
000198345 022__ $$a0342-4642
000198345 02470 $$2ISI$$a000332457400012
000198345 037__ $$aARTICLE
000198345 245__ $$aCerebral metabolic effects of exogenous lactate supplementation on the injured human brain
000198345 260__ $$bSpringer Verlag$$c2014$$aNew York
000198345 269__ $$a2014
000198345 300__ $$a10
000198345 336__ $$aJournal Articles
000198345 520__ $$aExperimental evidence suggests that lactate is neuroprotective after acute brain injury; however, data in humans are lacking. We examined whether exogenous lactate supplementation improves cerebral energy metabolism in humans with traumatic brain injury (TBI). We prospectively studied 15 consecutive patients with severe TBI monitored with cerebral microdialysis (CMD), brain tissue PO2 (PbtO(2)), and intracranial pressure (ICP). Intervention consisted of a 3-h intravenous infusion of hypertonic sodium lactate (aiming to increase systemic lactate to ca. 5 mmol/L), administered in the early phase following TBI. We examined the effect of sodium lactate on neurochemistry (CMD lactate, pyruvate, glucose, and glutamate), PbtO(2), and ICP. Treatment was started on average 33 +/- A 16 h after TBI. A mixed-effects multilevel regression model revealed that sodium lactate therapy was associated with a significant increase in CMD concentrations of lactate [coefficient 0.47 mmol/L, 95 % confidence interval (CI) 0.31-0.63 mmol/L], pyruvate [13.1 (8.78-17.4) mu mol/L], and glucose [0.1 (0.04-0.16) mmol/L; all p < 0.01]. A concomitant reduction of CMD glutamate [-0.95 (-1.94 to 0.06) mmol/L, p = 0.06] and ICP [-0.86 (-1.47 to -0.24) mmHg, p < 0.01] was also observed. Exogenous supplemental lactate can be utilized aerobically as a preferential energy substrate by the injured human brain, with sparing of cerebral glucose. Increased availability of cerebral extracellular pyruvate and glucose, coupled with a reduction of brain glutamate and ICP, suggests that hypertonic lactate therapy has beneficial cerebral metabolic and hemodynamic effects after TBI.
000198345 6531_ $$aBrain metabolism
000198345 6531_ $$aLactate
000198345 6531_ $$aCerebral microdialysis
000198345 6531_ $$aTraumatic brain injury
000198345 6531_ $$aHypertonic
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Intens Care Med, Neurosci Crit Care Res Grp, CH-1011 Lausanne, Switzerland$$aBouzat, Pierre
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Intens Care Med, Neurosci Crit Care Res Grp, CH-1011 Lausanne, Switzerland$$aSala, Nathalie
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Intens Care Med, Neurosci Crit Care Res Grp, CH-1011 Lausanne, Switzerland$$aSuys, Tamarah
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Radiol, CH-1011 Lausanne, Switzerland$$aZerlauth, Jean-Baptiste
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Inst Social & Prevent Med, CH-1011 Lausanne, Switzerland$$aMarques-Vidal, Pedro
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Internal Med, Div Clin Pathophysiol, CH-1011 Lausanne, Switzerland$$aFeihl, Francois
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Clin Neurosci, Div Neurosurg, CH-1011 Lausanne, Switzerland$$aBloch, Jocelyne
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Clin Neurosci, Div Neurosurg, CH-1011 Lausanne, Switzerland$$aMesserer, Mahmoud
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Clin Neurosci, Div Neurosurg, CH-1011 Lausanne, Switzerland$$aLevivier, Marc
000198345 700__ $$uUniv Lausanne Hosp, Fac Biol & Med, Dept Radiol, CH-1011 Lausanne, Switzerland$$aMeuli, Reto
000198345 700__ $$0243698$$g134990$$aMagistretti, Pierre J.
000198345 700__ $$aOddo, Mauro$$uUniv Lausanne Hosp, Fac Biol & Med, Dept Intens Care Med, Neurosci Crit Care Res Grp, CH-1011 Lausanne, Switzerland
000198345 773__ $$j40$$tIntensive Care Medicine$$k3$$q412-421
000198345 909C0 $$xU11150$$0252265$$pLNDC
000198345 909CO $$qSV$$particle$$ooai:infoscience.tind.io:198345
000198345 917Z8 $$x219572
000198345 937__ $$aEPFL-ARTICLE-198345
000198345 973__ $$rREVIEWED$$sPUBLISHED$$aEPFL
000198345 980__ $$aARTICLE