Cerebral tissue lactate in experimental oligemic shock

Robert A. Feldman M.D. 1 , David Yashon M.D., F.R.C.S. (C) 1 , George E. Locke M.D., F.R.C.S. (C) 1 and William E. Hunt M.D. 1
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  • 1 Division of Neurological Surgery, College of Medicine, Ohio State University, Columbus, Ohio
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✓ Eleven anesthetized dogs underwent bilateral craniectomies. Four control dogs had serial resections of cerebral tissue in the normotensive state. After one control sample was removed from the remaining seven dogs, they were bled to a mean arterial pressure of 30 to 35 mm Hg and had cerebral tissue samples resected at 0, 30, and 60 min after the onset of hypotension. The tissue samples from the four normotensive dogs averaged 4.83 mM lactate/kg tissue with a range of 4.67 to 7.22 mM/kg. At 0 time post-shock the samples averaged 7.18 mM/kg, at 30 min post-shock 14.31 mM/kg, and at 60 min 18.76 mM/kg. It can be concluded that hemorrhagic shock causes a progressive elevation in cerebral tissue lactate, which correlates with the duration of shock. At low mean arterial pressures the brain is susceptible to the effects of poor tissue perfusion, which results in both inadequate oxygenation and lactate washout in spite of well-established mechanisms for preferential shunting of blood to the brain.

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Contributor Notes

Address reprint requests to: David Yashon, M.D., Division of Neurological Surgery, The Ohio State University Hospitals, 410 West 10th Avenue, Columbus, Ohio 43210.
  • 1.

    Bergmeyer H: Methods of Enzymatic Analysis. New York, Academic Press, 1965, ed 2, pp 254, 266–270 Bergmeyer H: Methods of Enzymatic Analysis. New York, Academic Press, 1965, ed 2, pp 254, 266–270

    • Search Google Scholar
    • Export Citation
  • 2.

    Danforth WH, , Naegle S, & Bing RJ: Effect of ischemia and reoxygenation on glycolytic reactions and adenosinetriphosphate in heart muscle. Circ Res 8:965971, 1960 Danforth WH, Naegle S, Bing RJ: Effect of ischemia and reoxygenation on glycolytic reactions and adenosinetriphosphate in heart muscle. Circ Res 8:965–971, 1960

    • Search Google Scholar
    • Export Citation
  • 3.

    Feldman RA, , Yashon D, & Locke GE, et al: Cerebral tissue lactate following exposure and cerebrectomy. (unpublished data) Feldman RA, Yashon D, Locke GE, et al: Cerebral tissue lactate following exposure and cerebrectomy. (unpublished data)

    • Search Google Scholar
    • Export Citation
  • 4.

    Finnerty FA Jr, , Witkin L, & Fazekas JF: Cerebral hemodynamics during cerebral ischemia induced by acute hypotension. J Clin Invest 33:12271232, 1954 Finnerty FA Jr, Witkin L, Fazekas JF: Cerebral hemodynamics during cerebral ischemia induced by acute hypotension. J Clin Invest 33:1227–1232, 1954

    • Search Google Scholar
    • Export Citation
  • 5.

    Gaevskaya MS: Biochemistry of the Brain During the Process of Dying and Resuscitation. New York, Consultants Bureau, 1964, ed 1 Gaevskaya MS: Biochemistry of the Brain During the Process of Dying and Resuscitation. New York, Consultants Bureau, 1964, ed 1

    • Search Google Scholar
    • Export Citation
  • 6.

    Golden, PF, & Jane JA: Survival following profound hypovolemia: role of heart, lung, and brain. J Trauma 9:784798, 1969 Golden, PF, Jane JA: Survival following profound hypovolemia: role of heart, lung, and brain. J Trauma 9:784–798, 1969

    • Search Google Scholar
    • Export Citation
  • 7.

    Hurwitz BS, & Wolfson SK Jr: Brain lactate in anoxia and hypothermia: relationship to brain viability. Exp Neurol 23:426434, 1969 Hurwitz BS, Wolfson SK Jr: Brain lactate in anoxia and hypothermia: relationship to brain viability. Exp Neurol 23:426–434, 1969

    • Search Google Scholar
    • Export Citation
  • 8.

    Kovách AGB, , Róheim PS, & Irányi M, et al: Effect of the isolated perfusion of the head on the development of ischaemic and haemorrhagic shock. Acta Physiol Acad Sci Hung 14:231238, 1958 Kovách AGB, Róheim PS, Irányi M, et al: Effect of the isolated perfusion of the head on the development of ischaemic and haemorrhagic shock. Acta Physiol Acad Sci Hung 14:231–238, 1958

    • Search Google Scholar
    • Export Citation
  • 9.

    Lassen NA: Autoregulation of cerebral blood flow. Circ Res 15 Suppl 1:201204, 1964 Lassen NA: Autoregulation of cerebral blood flow. Circ Res 15 Suppl 1:201–204, 1964

    • Search Google Scholar
    • Export Citation
  • 10.

    Lewis AJ, & Zingg W: Experimental brain damage in dogs due to systemic, induced hypotension and head-up tilt for short periods. Angiology 17:800818, 1966 Lewis AJ, Zingg W: Experimental brain damage in dogs due to systemic, induced hypotension and head-up tilt for short periods. Angiology 17:800–818, 1966

    • Search Google Scholar
    • Export Citation
  • 11.

    Lillehei RC, , Longerbeam JK, & Bloch JH, et al: The nature of irreversible shock: experimental and clinical observations. Ann Surg 160:682710, 1964 Lillehei RC, Longerbeam JK, Bloch JH, et al: The nature of irreversible shock: experimental and clinical observations. Ann Surg 160:682–710, 1964

    • Search Google Scholar
    • Export Citation
  • 12.

    McIlwain H: Biochemistry and the Central Nervous System. Boston, 1959, ed 2 McIlwain H: Biochemistry and the Central Nervous System. Boston, 1959, ed 2

    • Search Google Scholar
    • Export Citation
  • 13.

    Reulen HJ, , Steude U, & Brendel W, et al: Elektrolyt- and Metabolitkonzentrationen im Gehirn nach normovolämischer Drucksenkung. Z Ges Exp Med 146:241260, 1968 Reulen HJ, Steude U, Brendel W, et al: Elektrolyt- and Metabolitkonzentrationen im Gehirn nach normovolämischer Drucksenkung. Z Ges Exp Med 146:241–260, 1968

    • Search Google Scholar
    • Export Citation
  • 14.

    Robinson JS: Hypotension without hypoxia. Int Anesth Clin 5:467480, 1967 Robinson JS: Hypotension without hypoxia. Int Anesth Clin 5:467–480, 1967

    • Search Google Scholar
    • Export Citation
  • 15.

    Schumer W, & Sperling R: Shock and its effect on the cell. JAMA 205:215219, 1968 Schumer W, Sperling R: Shock and its effect on the cell. JAMA 205:215–219, 1968

    • Search Google Scholar
    • Export Citation
  • 16.

    Simeone FA: Hemorrhagic shock: metabolic effects. Science 141:536542, 1963 Simeone FA: Hemorrhagic shock: metabolic effects. Science 141:536–542, 1963

    • Search Google Scholar
    • Export Citation
  • 17.

    Stone HH, , Donnelly CC, & MacKrell TN, et al: The effect of acute hemorrhagic shock on cerebral circulation and metabolism of man, in Mills LC, & Moyer JH (eds): Shock and Hypotension: Pathogenesis and Treatment. New York, Grune & Stratton, 1965, pp 257264 Stone HH, Donnelly CC, MacKrell TN, et al: The effect of acute hemorrhagic shock on cerebral circulation and metabolism of man, in Mills LC, Moyer JH (eds): Shock and Hypotension: Pathogenesis and Treatment. New York, Grune & Stratton, 1965, pp 257–264

    • Search Google Scholar
    • Export Citation
  • 18.

    Stone WE, , Marshall C, & Nims LF: Chemical changes in the brain produced by injury and by anoxia. Amer J Physiol 132:770775, 1941 Stone WE, Marshall C, Nims LF: Chemical changes in the brain produced by injury and by anoxia. Amer J Physiol 132:770–775, 1941

    • Search Google Scholar
    • Export Citation
  • 19.

    Trinkle JK, & Bryant LR: The metabolic effect of fluoride inhibition of anaerobic glycolysis during hemorrhagic shock. J Surg Res 9:583586, 1969 Trinkle JK, Bryant LR: The metabolic effect of fluoride inhibition of anaerobic glycolysis during hemorrhagic shock. J Surg Res 9:583–586, 1969

    • Search Google Scholar
    • Export Citation
  • 20.

    Wiggers CJ: Physiology of Shock. New York, Commonwealth Fund, 1950 Wiggers CJ: Physiology of Shock. New York, Commonwealth Fund, 1950

  • 21.

    Yashon D, , Locke GE, & Bingham WG Jr, et al: Cerebral physiologic function during profound oligemic hypotension. J Neurosurg 34:494499, 1971 Yashon D, Locke GE, Bingham WG Jr, et al: Cerebral physiologic function during profound oligemic hypotension. J Neurosurg 34:494–499, 1971

    • Search Google Scholar
    • Export Citation
  • 22.

    Yashon D, , Wagner FC Jr, & Demian YK, et al: Cerebral lactate accumulation and glucose exhaustion during circulatory arrest. Proc Soc Exp Biol Med 133:728730, 1970 Yashon D, Wagner FC Jr, Demian YK, et al: Cerebral lactate accumulation and glucose exhaustion during circulatory arrest. Proc Soc Exp Biol Med 133:728–730, 1970

    • Search Google Scholar
    • Export Citation

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