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dc.contributor.authorQuintard, Hervé
dc.contributor.authorPatet, Camille
dc.contributor.authorZerlauth, Jean-Baptiste
dc.contributor.authorSuys, Tamarah
dc.contributor.authorBouzat, Pierre
dc.contributor.authorPellerin, Luc
dc.contributor.authorMeuli, Reto
dc.contributor.authorMagistretti, Pierre J.
dc.contributor.authorOddo, Mauro
dc.date.accessioned2016-11-03T08:29:12Z
dc.date.available2016-11-03T08:29:12Z
dc.date.issued2015-09-30
dc.identifier.citationQuintard H, Patet C, Zerlauth J-B, Suys T, Bouzat P, et al. (2016) Improvement of Neuroenergetics by Hypertonic Lactate Therapy in Patients with Traumatic Brain Injury Is Dependent on Baseline Cerebral Lactate/Pyruvate Ratio. Journal of Neurotrauma 33: 681–687. Available: http://dx.doi.org/10.1089/neu.2015.4057.
dc.identifier.issn0897-7151
dc.identifier.issn1557-9042
dc.identifier.doi10.1089/neu.2015.4057
dc.identifier.urihttp://hdl.handle.net/10754/621433
dc.description.abstractEnergy dysfunction is associated with worse prognosis after traumatic brain injury (TBI). Recent data suggest that hypertonic sodium lactate infusion (HL) improves energy metabolism after TBI. Here, we specifically examined whether the efficacy of HL (3h infusion, 30-40 μmol/kg/min) in improving brain energetics (using cerebral microdialysis [CMD] glucose as a main therapeutic end-point) was dependent on baseline cerebral metabolic state (assessed by CMD lactate/pyruvate ratio [LPR]) and cerebral blood flow (CBF, measured with perfusion computed tomography [PCT]). Using a prospective cohort of 24 severe TBI patients, we found CMD glucose increase during HL was significant only in the subgroup of patients with elevated CMD LPR >25 (n = 13; +0.13 [95% confidence interval (CI) 0.08-0.19] mmol/L, p < 0.001; vs. +0.04 [-0.05-0.13] in those with normal LPR, p = 0.33, mixed-effects model). In contrast, CMD glucose increase was independent from baseline CBF (coefficient +0.13 [0.04-0.21] mmol/L when global CBF was <32.5 mL/100 g/min vs. +0.09 [0.04-0.14] mmol/L at normal CBF, both p < 0.005) and systemic glucose. Our data suggest that improvement of brain energetics upon HL seems predominantly dependent on baseline cerebral metabolic state and support the concept that CMD LPR - rather than CBF - could be used as a diagnostic indication for systemic lactate supplementation following TBI. Copyright © 2016 Mary Ann Liebert, Inc.
dc.publisherMary Ann Liebert Inc
dc.subjectcerebral blood flow
dc.subjectcerebral microdialysis
dc.subjecthypertonic
dc.subjectlactate
dc.subjecttraumatic brain injury
dc.titleImprovement of Neuroenergetics by Hypertonic Lactate Therapy in Patients with Traumatic Brain Injury Is Dependent on Baseline Cerebral Lactate/Pyruvate Ratio
dc.typeArticle
dc.contributor.departmentBiological and Environmental Sciences and Engineering (BESE) Division
dc.identifier.journalJournal of Neurotrauma
dc.contributor.institutionDepartment of Intensive Care Medicine, Neuroscience Critical Care Research Group, Lausanne, Switzerland
dc.contributor.institutionDepartment of Anesthesia and Intensive Care, Nice University Hospital, Nice, France
dc.contributor.institutionDepartment of Medical Radiology, Lausanne University Hospital, Lausanne, Switzerland
dc.contributor.institutionDepartment of Anesthesia and Intensive Care, Grenoble University Hospital, Grenoble, France
dc.contributor.institutionInstitute of Physiology, University of Lausanne, Lausanne, Switzerland
dc.contributor.institutionCentre de Neurosciences Psychiatriques, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, Lausanne, Switzerland
dc.contributor.institutionLaboratory of Neuroenergetics and Cellular Dynamics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
dc.contributor.institutionDepartment of Intensive Care Medicine, CHUV-University Hospital, Rue du Bugnon 46, BH 08.623, Lausanne, Switzerland
kaust.personMagistretti, Pierre J.


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