Role of hypertonic sodium lactate in traumatic brain injury management

Arifianto, Muhammad Reza; Ma'ruf, Achmad Zuhro; Ibrahim, Arsyik; Bajamal, Abdul Hafid

doi:10.4103/ajns.ajns_10_17

Cited by 10 publications

(6 citation statements)

References 43 publications

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“…One of these studies even indicated that TBI patients whose serum lactate >5 mmol/L were likely to have better survival than those with relatively low lactate level (24). Furthermore, the exogenous supplement of lactate by infusing hypertonic sodium lactate has been verified beneficial for survival and neurologic outcome and cognitive recovery in TBI animal models and patients (26)(27)(28)(29)(30)(31)(32). In our study, serum lactate was higher in non-survivors than survivors and was useful in predicting mortality in moderate to severe TBI patients with an AUC of 0.733.…”

Section: Discussionmentioning

confidence: 99%

“…The beneficial effects of hypertonic sodium lactate on the injured brain have been definitely recognized, i.e., improving cerebral perfusion and brain glucose availability, reversing impaired brain metabolism, and oxygenation. (26)(27)(28). In addition to the function of neuroenergetic material, lactate is actually a crucial signaling molecule, which could modulate the production of pentose phosphate, an important molecule to prevent oxidative stress injury in brain (40)(41)(42)(43).…”

Section: Discussionmentioning

confidence: 99%

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Lactate Albumin Ratio Is Associated With Mortality in Patients With Moderate to Severe Traumatic Brain Injury

Wang

et al. 2022

Front. Neurol.

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BackgroundTraumatic brain injury (TBI) is a serious public health issue all over the world. This study was designed to evaluate the prognostic value of lactate to albumin ratio (LAR) on patients with moderate to severe TBI.MethodsClinical data of 273 moderate to severe TBI patients hospitalized in West China Hospital between May 2015 and January 2018 were collected. Multivariate logistic regression analyses were used to explore risk factors and construct a prognostic model of in-hospital mortality in this cohort. A receiver operating characteristic (ROC) curve was drawn to evaluate the discriminative ability of this model.ResultsNon-survivors had higher LAR than survivors (1.09 vs. 0.53, p < 0.001). Results of multivariate logistic regression analysis showed that Glasgow Coma Scale (GCS; odds ratio [OR] = 0.743, p = 0.001), blood glucose (OR = 1.132, p = 0.005), LAR (OR = 1.698, p = 0.022), subdural hematoma (SDH; OR = 2.889, p = 0.006), intraparenchymal hemorrhage (IPH; OR = 2.395, p = 0.014), and diffuse axonal injury (DAI; OR = 2.183, p = 0.041) were independent risk factors of in-hospital mortality in included patients. These six factors were utilized to construct the prognostic model. The area under the ROC curve (AUC) values of single lactate, albumin, and LAR were 0.733 (95% Cl; 0.673–0.794), 0.740 (95% Cl; 0.683–0.797), and 0.780 (95% Cl; 0.725–0.835), respectively. The AUC value of the prognostic model was 0.857 (95%Cl; 0.812–0.901), which was higher than that of LAR (Z = 2.1250, p < 0.05).ConclusionsLactate to albumin ratio is a readily available prognostic marker of moderate to severe TBI patients. A prognostic model incorporating LAR is beneficial for clinicians to evaluate possible progression and make treatment decisions in TBI patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lactate Albumin Ratio Is Associated With Mortality in Patients With Moderate to Severe Traumatic Brain Injury

Wang

et al. 2022

Front. Neurol.

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“…One of these studies even indicated that TBI patients whose serum lactate > 5 mmol/L were likely to have a better survival than those with relatively low lactate level [24]. Furthermore, exogenous supplement of lactate by infusing hypertonic sodium lactate has been veri ed bene cial for survival and neurologic outcome and cognitive recovery in TBI animal models and patients [26][27][28][29][30][31][32]. In our study, serum lactate was higher in nonsurvivors than survivors, and was useful in predicting mortality in moderate to severe TBI patients with AUC of 0.733.…”

Section: Discussionmentioning

confidence: 99%

“…The bene cial effects of hypertonic sodium lactate on injured brain has been de nitely recognized including improving cerebral perfusion and brain glucose availability, reversing impaired brain metabolism and oxygenation, etc. [26][27][28]. In addition to the function of neuroenergetic material, lactate is actually a crucial signaling molecule which could modulate the production of pentose phosphate, an important molecule to prevent oxidative stress injury in brain [40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Lactate Albumin Ratio is Associated with Mortality in Patients with Moderate to Severe Traumatic Brain Injury

Wang¹,

He²,

Ou³

et al. 2020

Preprint

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Abstract Background: Traumatic brain injury (TBI) is a serious public health issue all over the world. This study was designed to evaluate the prognostic value of lactate to albumin ratio (LAR) on moderate to severe traumatic brain injury.Methods: Clinical data of 273 moderate to severe TBI patients hospitalized in West China Hospital between May 2015 and January 2018 were collected. Multivariate logistic regression analyses were used to explore risk factors and construct prognostic model of in-hospital mortality in this cohort. Nomogram was drawn to visualize the prognostic model. Receiver operating characteristic (ROC) curve and calibration curve were respectively drawn to evaluate discriminative ability and stability of this model.Results: Non-survivors had higher LAR than survivors (1.0870 vs 0.5286, p<0.001). Results of multivariate logistic regression analysis showed that GCS (OR=0.818, p=0.008), blood glucose (OR=1.232, p<0.001), LAR (OR=1.883, p=0.012), and red blood cell distribution (RDW)-SD (OR=1.179, p=0.004) were independent risk factors of in-hospital mortality in included patients. These four factors were utilized to construct prognostic model. The area under the ROC curve (AUC) value of single lactate and LAR were 0.733 (95%Cl; 0.673-0.794) and 0.780 (95%Cl; 0.725-0.835), respectively. The AUC value of the prognostic model was 0.868 (95%Cl; 0.826-0.909), which was higher than that of LAR (Z=2.5143, p<0.05).Conclusions: LAR is a readily available prognostic marker of moderate to severe TBI patients. Prognostic model incorporating LAR is beneficial for clinicians to evaluate possible progression and make treatment decisions in these patients.

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“…Ichai et al mentioned that HSL's effect was even more potent than mannitol's effect on reducing ICP in some trials (Ichai et al, 2009). It is noteworthy that a recent study on patients with TBI-induced elevated ICP, Arifianto et al introduced HSL as a choice for fluid therapy (Arifianto et al, 2018). Considering HSL's beneficial roles in TBI, in this study, we systematically reviewed the articles investigating HSL's therapeutic role in patients with traumatic brain injury.…”

Section: Introductionmentioning

confidence: 99%

Effects of Hypertonic Sodium Lactate on Intracranial Pressure in Patients with Traumatic Brain Injury: A Systematic Review and Metanalysis on Clinical Trial Studies

Mosaed

Rezayat²,

Rohani³

et al. 2022

BCN

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Introduction: Intracranial pressure (ICP) elevation leading to cerebral edema is a critical condition that should be identified and treated immediately. In this study, we systematically reviewed the articles investigating the role of hypertonic sodium lactate (HSL) in patients with traumatic brain injury. Method: PubMed, Scopus, EMBASE, and Web of Science were searched to find published articles on the effects of HSL on ICP in patients with a traumatic brain injury until December 2020. Animal studies, case reports, and studies, including liver and renal failure patients, cardiac dysfunction, or hypovolemic shock, were excluded. The Newcastle–Ottawa Scale checklist was used to assess the methodological quality of eligible articles. Information was gathered based on the following: Demographic data, methods, intervention, and outcomes. Results: Our initial search with the predefined search strategy proceeded 113 studies. Finally, seven studies were eligible for systematic review, which three of them were eligible for meta-analysis. A random meta-analysis of three articles comparing ICP before and after the infusion of HSL showed a reduced ICP following the use of HSL in traumatic brain injuries (P=0.015). Conclusion: Our study demonstrated hypertonic sodium lactate's undeniable role in managing increased ICP in patients with brain injury. Nevertheless, conducting more clinical studies for assessing the possible side effects of HSL seems crucial.

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Role of hypertonic sodium lactate in traumatic brain injury management

Cited by 10 publications

References 43 publications

Lactate Albumin Ratio Is Associated With Mortality in Patients With Moderate to Severe Traumatic Brain Injury

Lactate Albumin Ratio Is Associated With Mortality in Patients With Moderate to Severe Traumatic Brain Injury

Lactate Albumin Ratio is Associated with Mortality in Patients with Moderate to Severe Traumatic Brain Injury

Effects of Hypertonic Sodium Lactate on Intracranial Pressure in Patients with Traumatic Brain Injury: A Systematic Review and Metanalysis on Clinical Trial Studies

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