ArticleIntensive care medicine experimental2019
Moderately prolonged permissive hypotension results in reversible metabolic perturbation evaluated by intracerebral microdialysis - an experimental animal study.
Article in Intensive care medicine experimental, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- A randomized, double-blind trial comparing the effect of two blood pressure targets on global brain metabolism after out-of-hospital cardiac arrest.Critical care (London, England) · 2023Trial
- Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest.Scientific reports · 2021Trial
- Resuscitative endovascular occlusion of the aorta restores cerebral metabolic markers of ischaemia induced by haemorrhagic shock.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Cerebral glycerol during haemorrhagic shock in normal and raised intracranial pressure resuscitated with total REBOA: an experimental porcine study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Cerebral microdialysis values in healthy brain tissue - a scoping review.Acta neurochirurgica · 2025Article
- Succinate prodrugs in combination with atropine and pralidoxime protect cerebral mitochondrial function in a rodent model of acute organophosphate poisoning.Scientific reports · 2022Article
- Effects of norepinephrine infusion on cerebral energy metabolism during experimental haemorrhagic shock.Intensive care medicine experimental · 2022Article
- Brain Histology and Immunohistochemistry After Resuscitation From Hemorrhagic Shock in Swine With Pre-Existing Atherosclerosis and Sodium Thiosulfate (NaFrontiers in medicine · 2022Article
- Bedside interpretation of cerebral energy metabolism utilizing microdialysis in neurosurgical and general intensive care.Frontiers in neurology · 2022Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDamage control resuscitation (DCR) and damage control surgery (DCS) is the main strategy in patients with uncontrollable hemorrhagic shock. One aspect of DCR is permissive hypotension. However, the duration of hypotension that can be tolerated without affecting the brain is unknown. In the present study we investigate the effect of 60 min severe hypotension on the brain's energy metabolism and seek to verify earlier findings that venous cerebral blood can be used as a marker of global cerebral energy state. MATERIAL AND
methodsTen pigs were anaesthetized, and vital parameters recorded. Microdialysis catheters were placed in the left parietal lobe, femoral artery, and superior sagittal sinus for analysis of lactate, pyruvate, glucose, glycerol, and glutamate. Hemorrhagic shock was induced by bleeding the animal until mean arterial pressure (MAP) of 40 mmHg was achieved. After 60 min the pigs were resuscitated with autologous blood and observed for 3 h.
resultsAt baseline the lactate to pyruvate ratios (LP ratio) in the hemisphere, artery, and sagittal sinus were (median (interquartile range)) 13 (8-16), 21 (18-24), and 9 (6-22), respectively. After induction of hemorrhagic shock, the LP ratio from the left hemisphere in 9 pigs increased to levels indicating a reversible perturbation of cerebral energy metabolism 19 (12-30). The same pattern was seen in LP measurements from the femoral artery 28 (20-35) and sagittal sinus 22 (19-26). At the end of the experiment hemisphere, artery and sinus LP ratios were 16 (10-23), 17 (15-25), and 17 (10-27), respectively. Although hemisphere and sinus LP ratios decreased, they did not reach baseline levels (p < 0.05). In one pig hemisphere LP ratio increased to a level indicating irreversible metabolic perturbation (LP ratio > 200).
conclusionDuring 60 min of severe hypotension intracerebral microdialysis shows signs of perturbations of cerebral energy metabolism, and these changes trend towards baseline values after resuscitation. Sagittal sinus microdialysis values followed hemisphere values but were not distinguishable from systemic arterial values. Venous (jugular bulb) microdialysis might have a place in monitoring conditions where global cerebral ischemia is a risk.
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