Hypertonic lactate for the treatment of intracranial hypertension in patients with acute brain injury
| Autor: | Adriano Bernini, John-Paul Miroz, Samia Abed-Maillard, Eva Favre, Carolina Iaquaniello, Nawfel Ben-Hamouda, Mauro Oddo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Adult
Male Saline Solution Hypertonic Multidisciplinary Hypertonic Solutions Middle Aged Brain Injuries/complications Female Humans Intracranial Hypertension/drug therapy Intracranial Hypertension/etiology Lactates/administration & dosage Retrospective Studies Saline Solution Hypertonic/administration & dosage Treatment Outcome Young Adult Brain Injuries Lactates Intracranial Hypertension |
| Zdroj: | Scientific reports, vol. 12, no. 1, pp. 3035 |
| Popis: | Hypertonic lactate (HL) is emerging as alternative treatment of intracranial hypertension following acute brain injury (ABI), but comparative studies are limited. Here, we examined the effectiveness of HL on main cerebral and systemic physiologic variables, and further compared it to that of standard hypertonic saline (HS). Retrospective cohort analysis of ABI subjects who received sequential osmotherapy with 7.5% HS followed by HL—given at equi-osmolar (2400 mOsmol/L) and isovolumic (1.5 mL/kg) bolus doses—to reduce sustained elevations of ICP (> 20 mmHg). The effect of HL on brain (intracranial pressure [ICP], brain tissue PO2 [PbtO2], cerebral microdialysis [CMD] glucose and lactate/pyruvate ratio [LPR]) and blood (chloride, pH) variables was examined at different time-points (30, 60, 90, 120 min vs. baseline), and compared to that of HS. A total of 34 treatments among 17 consecutive subjects (13 traumatic brain injury [TBI], 4 non-TBI) were studied. Both agents significantly reduced ICP (p p > 0.2). None of the treatment had statistically significant effects on PbtO2 and CMD biomarkers. Treatment with HL did not cause hyperchloremia and resulted in a more favourable systemic chloride balance than HS (Δ blood chloride − 1 ± 2.5 vs. + 4 ± 3 mmol/L; p |
| Databáze: | OpenAIRE |
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