Home Bratislava Medical Journal 2018 Bratislava Medical Journal Vol.119, No.3, p.139-142, 2018

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

Impact factor 1.564


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Bratislava Medical Journal Vol.119, No.3, p.139-142, 2018

Title: The relationship between intracranial pressure and lactate/pyruvate ratio in patients with subarachnoid haemorrhage
Author: T. Cesak, J. Adamkov, J. Habalova, P. Poczos, M. Kanta, M. Bartos, T. Hosszu


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).

Keywords: subarachnoid haemorrhage, intracranial pressure, brain microdialysis, lactate/pyruvate ratio
Published online: 06-Mar-2018
Year: 2018, Volume: 119, Issue: 3 Page From: 139, Page To: 142

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