open access
Regional cerebral blood flow and cellular environment in subarachnoid hemorrhage: A thermal doppler flowmetry and microdialysis study
- Intensive Care Unit, General Hospital of Larisa, Greece
- Department of Neurosurgery, Boston University
- Department of Anesthesiology, University Hospital of Larisa, Greece
- Department of Neurosurgery, University Hospital of Larisa, Greece
open access
Abstract
Cerebral microdialysis enables assessment of regional metabolic physiology and provides biomarkers for clinical correlation in critical conditions, such as subarachnoid hemorrhage (SAH). The aim of our current study was to investigate the correlation between regional cerebral blood flow and microdialysis parameters (glucose, lactate, glycerol, pyruvate concentrations, and lactate/pyruvate metabolic ratio) in patients with SAH.
Materials and methodsTwenty-one patients with SAH were enrolled in our retrospective study. Cerebral blood flow (CBF) based on thermal diffusion methodology, the thermal coefficient K, and microdialysis biochemical markers were recorded. The duration of the brain monitoring was 10 days.
ResultsMicrodialysis glucose concentration was inversely related to the cerebral temperature and to the L/P ratio. Furthermore, it was positively correlated to all other microdialysis parameters but glycerol. The K coefficient was strongly and positively correlated with the temperature and marginally with the CBF. The L/P ratio was positively correlated with glycerol, while it was inversely correlated with the CBF. Patients who died had elevated L/P ratio and K coefficient compared to the survivors in our series.
ConclusionsThermal conductivity coefficient may change over time as cerebral injury progresses and tissue properties alter. These alterations were found to be associated with the microdialysis metabolite concentrations and the CBF itself. The microdialysis biochemical indices of cell stress and death (glycerol, L/P ratio) were positively related to each other, while the measured L/P metabolic ratio was higher among patients who died.
Abstract
Cerebral microdialysis enables assessment of regional metabolic physiology and provides biomarkers for clinical correlation in critical conditions, such as subarachnoid hemorrhage (SAH). The aim of our current study was to investigate the correlation between regional cerebral blood flow and microdialysis parameters (glucose, lactate, glycerol, pyruvate concentrations, and lactate/pyruvate metabolic ratio) in patients with SAH.
Materials and methodsTwenty-one patients with SAH were enrolled in our retrospective study. Cerebral blood flow (CBF) based on thermal diffusion methodology, the thermal coefficient K, and microdialysis biochemical markers were recorded. The duration of the brain monitoring was 10 days.
ResultsMicrodialysis glucose concentration was inversely related to the cerebral temperature and to the L/P ratio. Furthermore, it was positively correlated to all other microdialysis parameters but glycerol. The K coefficient was strongly and positively correlated with the temperature and marginally with the CBF. The L/P ratio was positively correlated with glycerol, while it was inversely correlated with the CBF. Patients who died had elevated L/P ratio and K coefficient compared to the survivors in our series.
ConclusionsThermal conductivity coefficient may change over time as cerebral injury progresses and tissue properties alter. These alterations were found to be associated with the microdialysis metabolite concentrations and the CBF itself. The microdialysis biochemical indices of cell stress and death (glycerol, L/P ratio) were positively related to each other, while the measured L/P metabolic ratio was higher among patients who died.
Keywords
Cerebral blood flow, K coefficient, Microdialysis, Subarachnoid hemorrhage, Thermal conductivity, Brain water content
Title
Regional cerebral blood flow and cellular environment in subarachnoid hemorrhage: A thermal doppler flowmetry and microdialysis study
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
66-71
Page views
383
Article views/downloads
628
DOI
10.1016/j.pjnns.2016.11.002
Bibliographic record
Neurol Neurochir Pol 2017;51(1):66-71.
Keywords
Cerebral blood flow
K coefficient
Microdialysis
Subarachnoid hemorrhage
Thermal conductivity
Brain water content
Authors
D. Papadopoulos
A. Filippidis
G. Krommidas
G. Vretzakis
K. Paterakis
A. Komnos
K.N. Fountas