Neuroenergetic Response to Prolonged Cerebral Glucose Depletion after Severe Brain Injury and the Role of Lactate

Journal of Neurotrauma
Camille PatetMauro Oddo

Abstract

Lactate may represent a supplemental fuel for the brain. We examined cerebral lactate metabolism during prolonged brain glucose depletion (GD) in acute brain injury (ABI) patients monitored with cerebral microdialysis (CMD). Sixty episodes of GD (defined as spontaneous decreases of CMD glucose from normal to low [<1.0 mmol/L] for at least 2 h) were identified among 26 patients. During GD, we found a significant increase of CMD lactate (from 4 ± 2.3 to 5.4 ± 2.9 mmol/L), pyruvate (126.9 ± 65.1 to 172.3 ± 74.1 μmol/L), and lactate/pyruvate ratio (LPR; 27 ± 6 to 35 ± 9; all, p < 0.005), while brain oxygen and blood lactate remained normal. Dynamics of lactate and glucose supply during GD were further studied by analyzing the relationships between blood and CMD samples. There was a strong correlation between blood and brain lactate when LPR was normal (r = 0.56; p < 0.0001), while an inverse correlation (r = -0.11; p = 0.04) was observed at elevated LPR >25. The correlation between blood and brain glucose also decreased from r = 0.62 to r = 0.45. These findings in ABI patients suggest increased cerebral lactate delivery in the absence of brain hypoxia when glucose availability is limited and support the concept that lactate acts as...Continue Reading

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Citations

Feb 24, 2016·Current Neurology and Neuroscience Reports·Camille PatetMauro Oddo
May 20, 2015·Therapeutic Hypothermia and Temperature Management·M Ross BullockMichelle Hill
Nov 3, 2016·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Gerald A DienelCarl-Henrik Nordström
Nov 1, 2016·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Ibrahim JallohKeri Lh Carpenter
Apr 25, 2018·Journal of Neurotrauma·Ibrahim JallohKeri L H Carpenter
Oct 26, 2018·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Adriano BerniniMauro Oddo
Dec 20, 2018·Physiological Reviews·Gerald A Dienel
Mar 12, 2019·Current Opinion in Critical Care·Hervé Quintard, Carole Ichai
Mar 27, 2020·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Hélène RoumesAnne-Karine Bouzier-Sore
Jun 24, 2021·Journal of Neurochemistry·Jiru ZhouHua Feng

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