The relationship between intracranial pressure and lactate/pyruvate ratio in patients with subarachnoid haemorrhage.
Bratisl Lek Listy
; 119(3): 139-142, 2018.
Article
em En
| MEDLINE
| ID: mdl-29536741
ABSTRACT
AIM:
The aim of this study was to analyse the relationship between intracranial pressure (intracranial pressure monitoring) and lactate pyruvate ratio (cerebral microdialysis) in patients with ruptured intracranial aneurysms.METHODS:
In a group of fifteen patients, intracranial pressure and lactate/pyruvate ratios were measured and logged in hourly intervals. The relationship between these two variables was subsequently analysed in two ways. 1) Intracranial hypertension (ICP > 20 mmHg) in the presence of energy deprivation (L/P ratio > 30) was noted. 2) The dynamics of L/P ratio changes in relation to immediate ICP and CPP values was analysed.RESULTS:
Out of a total of 1873 monitored hours we were able to record lactate/pyruvate ratios higher than 30 in 832 hours (44 %). Of those 832 hours during which lactate/pyruvate ratios were higher than 30, ICP was higher than 20 in 193 hours (23 %). Out of 219 hours of monitoring, in which ICP was higher than 20, a simultaneously increased L/P ratio higher than 30 was recorded in 193 hours (88 %). L/P ratio values above 30 were associated with decreased CPP values (p = 0.04), but not with increased ICP values (p = 0.79).CONCLUSION:
Intracranial hypertension coincides with energetic imbalance in approximately one quarter of cases. This points to the shortcomings of the most common form of neuromonitoring in SAH patients - ICP monitoring. This method may not be reliable enough in detecting hypoxic damage, which is the major cause of morbidity and mortality in SAH patients (Fig. 5, Ref. 11).Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Hemorragia Subaracnóidea
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Encéfalo
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Pressão Intracraniana
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Ácido Láctico
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Ácido Pirúvico
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Hipertensão Intracraniana
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article