Evidence map›Paper›PMID 40229764›Full record

Trial reportCritical care (London, England)2025

Exogenous lactate infusion (ELI) in traumatic brain injury: higher dose is better?

Paul Vespa, Stephanie Wolahan, Manuel Buitrago-Blanco, Courtney Real, Jesus Ruiz-Tejeda, David L McArthur, Jeffrey N Chiang, Denes Agoston, Thomas C Glenn

Registry-linked trialAbstract readClinical TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02776488 (Exogenous Sodium Lactate Infusion in Traumatic Brain Injury), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02776488 phase2withdrawnnot on this map

Exogenous Sodium Lactate Infusion in Traumatic Brain Injury (ELI-TBI)

TypeinterventionalSponsorUniversity of California, Los AngelesRan2020 to 2026Enrolled0ConditionsBrain Injuries, TraumaticArmsSodium Lactate, Placebo
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Paul VespaUCLA Department of Neurology, UCLA Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, 757 Westwood Blvd., Room 6236 A, Los Angeles, CA, 90095, USA. pvespa@mednet.ucla.edu.
Stephanie WolahanUCLA Department of Neurology, UCLA Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, 757 Westwood Blvd., Room 6236 A, Los Angeles, CA, 90095, USA.
Manuel Buitrago-BlancoUCLA Department of Neurology, UCLA Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, 757 Westwood Blvd., Room 6236 A, Los Angeles, CA, 90095, USA.
Courtney RealUCLA Department of Neurology, UCLA Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, 757 Westwood Blvd., Room 6236 A, Los Angeles, CA, 90095, USA.
Jesus Ruiz-TejedaDepartment of Oncology, University of California, Irvine, Irvine, USA.
David L McArthurUCLA Department of Neurology, UCLA Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, 757 Westwood Blvd., Room 6236 A, Los Angeles, CA, 90095, USA.
Jeffrey N ChiangUCLA Department of Neurology, UCLA Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, 757 Westwood Blvd., Room 6236 A, Los Angeles, CA, 90095, USA.
Denes AgostonUniformed Services University, Bethesda, USA.
Thomas C GlennUCLA Department of Neurology, UCLA Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, 757 Westwood Blvd., Room 6236 A, Los Angeles, CA, 90095, USA.

Funding

The effects of glycemic control on post-traumatic brain metabolismP01NS058489 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI VESPA, PAUL M · 2009 to 2013
$6.2M
MRS Detects Metabolic Dysfunction after Brain InjuryR01NS049471 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI VESPA, PAUL M · 2006 to 2009
$1.3M
NINDS NIH HHS NS049471NINDS NIH HHS NS058489NINDS NIH HHS P01 NS058489NINDS NIH HHS R01 NS049471
6 · The paper itself

Abstract

BACKGROUND/

objectiveTraumatic brain injury (TBI) is a life-threatening critical neurological injury resulting in widespread metabolic dysfunction in need of novel metabolic therapy. Exogenous lactate appears to improve brain metabolism, but the dose of lactate required remains uncertain. However, the ideal dose of lactate remains unclear. We present a comparison of low vs high dose exogenous sodium lactate infusion in a small cohort and the previous existing literature. We propose a systematic protocol to better study the question of dose-effect n in a future larger study.

methodsWe analyzed the metabolic and physiologic effects of various doses of exogenous sodium lactate infusion (ELI) in the existing published literature and our own, single center cohort of patients with coma from severe TBI. Low dose ELI targeting arterial lactate concentration of 2-3 mMol was compared with high dose ELI targeting 4-6 mM. Effects of ELI on brain metabolism and intracranial pressure (ICP) were reviewed. A precision high-dose protocol was piloted and results compared against the existing literature.

resultsAcross various studies, metabolic response to ELI was variable and not consistently beneficial. High-dose ELI targeting arterial concentration of 4-6 mM resulted in consistent metabolic improvement and in ICP reduction (p < 0.01). The precision high dose protocol reliably resulted in higher arterial concentration.

conclusionsHigh dose ELI appears to have more consistent beneficial effects on brain metabolism and intracranial pressure.

trial registrationClinicalTrials.gov ID NCT02776488. Date registered: 2016-05-17. Retrospectively Registered.

Indexed as

Brain Injuries, TraumaticLactic AcidSodium LactateAdultCohort StudiesDose-Response Relationship, DrugFemaleHumansMaleMiddle AgedRetrospective StudiesLactic AcidSodium LactateComaIntracranial pressureLactateMetabolic crisisOxidative metabolismTraumatic brain injury

Identifiers

PMID40229764
PMCPMC11998250

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.