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Cerebrospinal fluid lactate and neurological outcome after subarachnoid haemorrhage

Artikel i vetenskaplig tidskrift
Författare C. Lindgren
L. O. Koskinen
R. Ssozi
Silvana Naredi
Publicerad i Journal of Clinical Neuroscience
Volym 60
Sidor 63-67
ISSN 0967-5868
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Sidor 63-67
Språk en
Länkar dx.doi.org/10.1016/j.jocn.2018.10.0...
Ämnesord Cerebral aneurysms, Cerebrovascular circulation, Endovascular procedures, Critical care outcomes, delayed cerebral-ischemia, metabolism, management, vasospasm, time
Ämneskategorier Neurologi

Sammanfattning

Background: Increased lactate in cerebrospinal fluid (CSF) has been regarded as a marker for cerebral ischemia and damage in the central nervous system. The aim of this study was to evaluate if CSF-lactate was associated with; impaired cerebral circulation, outcome, sex, age, clinical condition or treatment after subarachnoid haemorrhage (SAH). Methods: This study consists of 33 patients (22 females, 11 males) with aneurysmal SAH treated at Umea university hospital 2008-2009. Samples were obtained from external ventricular catheters 0-240 h after SAH. Normal CFS-lactate was defined as 1.2-2-1 mmol/L. Hunt & Hess scale assessed clinical condition. Impaired cerebral circulation was evaluated by clinical examination, transcranial doppler, CT-scan, and cerebral angiography. Glasgow outcome scale (GOS) evaluated outcome. Results: Seventy-nine CSF-lactate samples were analysed. CSF-lactate >2.1 mmol/L was found in 25/33 (76%) patients and in 50/79 (63%) samples. No difference in CSF-lactate levels was found over time. No association was found between patients with CSF-lactate >2.1 mmol/L and; sex, severity of clinical condition, impaired cerebral circulation or outcome. CSF-lactate >2.1 mmol/L was more common in patients >= 61 years of age (p = 0.04) and in patients treated with endovascular coiling compared to surgical clipping (p = 0.0001). Conclusion: In patients with SAH, no association was found between increased CSF-lactate (>2.1 mmol/L) and severe clinical condition, impaired cerebral circulation or unfavourable outcome. Endovascular coiling and age >= 61 years was associated with CSF-lactate above >2.1 mmol/L. (C) 2018 Published by Elsevier Ltd.

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