Article: article from journal or magazin.
Brain lactate by magnetic resonance spectroscopy during fulminant hepatic failure in the dog.
Liver Transplantation and Surgery
1527-6465; 1074-3022 (Print)
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.Publication Status: ppublish
A noninvasive test is needed to assess the severity of encephalopathy during fulminant hepatic failure. This feasibility study was designed to compare a noninvasive test, brain lactate measurement by magnetic resonance spectroscopy, with intracranial pressure monitoring in a large animal model of fulminant hepatic failure. Five dogs received an intraventricular catheter for intracranial pressure measurement. Liver injury was induced by intravenous bolus of D-galactosamine. Brain lactate concentrations were determined by magnetic resonance spectroscopy for up to 48 hours after D-galactosamine administration (t = 0 hour). A dose of D-galactosamine exceeding 1.5 g/kg resulted in fulminant hepatic failure. Brain lactate levels increased to > 10 mmol/L in the two dogs that developed severe intracranial hypertension of > 50 mm Hg and sustained cerebral perfusion pressures of < 40 mm Hg. Both dogs experienced brain death, 42 and 48 hours after the administration of D-galactosamine. Brain lactate concentrations determined by magnetic resonance spectroscopy were in agreement with brain tissue concentrations of lactate determined by high-performance liquid chromatography at necropsy. Plasma lactate concentrations were only mildly elevated (3.2 and 4.2 mmol/L) at the time of brain death. Elevated levels of brain lactate are associated with intracranial hypertension and poor neurological outcome during fulminant hepatic failure.
Animals, Biological Markers/analysis, Brain/metabolism, Dogs, Dose-Response Relationship, Drug, Feasibility Studies, Galactosamine/pharmacology, Glutamic Acid/metabolism, Glutamine/metabolism, Hepatic Encephalopathy/chemically induced, Hepatic Encephalopathy/metabolism, Intracranial Hypertension/physiopathology, Lactic Acid/blood, Lactic Acid/metabolism, Magnetic Resonance Spectroscopy, Male, Time Factors
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