Cerebral multimodal monitoring in sepsis: an experimental study

Detalhes bibliográficos
Autor(a) principal: Kurtz, Pedro
Data de Publicação: 2019
Outros Autores: D’Avila, Joana C., Prado, Darwin, Madeira, Caroline, Vargas-Lopes, Charles, Panizzutti, Rogerio, Azevedo, Luciano C.P., Bozza, Fernando A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/32293
Resumo: 2020-03-01
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spelling Kurtz, PedroD’Avila, Joana C.Prado, DarwinMadeira, CarolineVargas-Lopes, CharlesPanizzutti, RogerioAzevedo, Luciano C.P.Bozza, Fernando A.2019-03-29T13:31:15Z2019-03-29T13:31:15Z2019KURTZ, Pedro et al. Cerebral multimodal monitoring in sepsis: an experimental study. Shock, v. 51, n. 2, p. 228-234, 2019.1073-2322https://www.arca.fiocruz.br/handle/icict/3229310.1097/SHK.00000000000011381540-0514engLippincott, Williams & WilkinsCerebral multimodal monitoring in sepsis: an experimental studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2020-03-01Paulo Niemeyer State Brain Institute. Rio de Janeiro, RJ, Brazil.Sem afiliação.Sem afiliação.Sem afiliação.Sem afiliação.Sem afiliação.Sem afiliação.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia. Rio de Janeiro, RJ, Brasil / Instituto D’Or de Ensino e Pesquisa. Rio de Janeiro, RJ, Brasil.Acute brain dysfunction is a complication of sepsis, and its pathophysiology remains poorly understood. We studied the brain metabolism in a resuscitated animal model of sepsis. Twelve anesthetized, mechanically ventilated, and invasively monitored pigs were allocated to a sham procedure (N ¼ 5) or sepsis (N ¼ 7). Sepsis was induced through fecal inoculation in the peritoneum. Fluid resuscitation was maintained during the entire study period. Animals were observed until spontaneous death or for a maximum of 24 h. In addition to global hemodynamic and laboratory assessment, intracranial pressure and cerebral microdialysis (MD) were evaluated at baseline, 6, 12, 18, and 24 h after sepsis induction. After euthanasia, the brain was rapidly removed and a fragment from the frontal cortex was analyzed for markers of neuroinflammation, metabolism, and neurotransmission. Septic animals developed a hyperdynamic state associated with increased arterial lactate. Cerebral microdialysis showed unchanged levels of lactate/pyruvate ratios and brain glucose between the groups. Brain/serum glucose ratios were increased in the septic animals during the study period despite a progressive decrease in serum glucose. Moreover, extracellular glutamine levels were elevated starting at 6 h after sepsis. Tissue analysis showed elevated glutamate, glutamine, and glutamine synthetase in the sepsis group. However, C-Fos, a marker of neuronal activity, was unchanged between groups. In this animal model of resuscitated sepsis, we found increased oxidative stress and alterations in neuroenergetics characterized by exacerbated activity of the glutamate/glutamine cycle and increased glucose utilization by the brain, however without any evidence of decompensated energy metabolism.Acute brain dysfunctionCerebral multimodality monitoringSepsis-associated encephalopathyinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83104https://www.arca.fiocruz.br/bitstream/icict/32293/1/license.txt79178e5f2a0eb066867a274556814938MD51ORIGINALve_Kurtz_Pedro_etal_INI_2019.pdfve_Kurtz_Pedro_etal_INI_2019.pdfapplication/pdf661317https://www.arca.fiocruz.br/bitstream/icict/32293/2/ve_Kurtz_Pedro_etal_INI_2019.pdf5483339823826132960ea3954cda48e9MD52TEXTve_Kurtz_Pedro_etal_INI_2019.pdf.txtve_Kurtz_Pedro_etal_INI_2019.pdf.txtExtracted 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dc.title.pt_BR.fl_str_mv Cerebral multimodal monitoring in sepsis: an experimental study
title Cerebral multimodal monitoring in sepsis: an experimental study
spellingShingle Cerebral multimodal monitoring in sepsis: an experimental study
Kurtz, Pedro
Acute brain dysfunction
Cerebral multimodality monitoring
Sepsis-associated encephalopathy
title_short Cerebral multimodal monitoring in sepsis: an experimental study
title_full Cerebral multimodal monitoring in sepsis: an experimental study
title_fullStr Cerebral multimodal monitoring in sepsis: an experimental study
title_full_unstemmed Cerebral multimodal monitoring in sepsis: an experimental study
title_sort Cerebral multimodal monitoring in sepsis: an experimental study
author Kurtz, Pedro
author_facet Kurtz, Pedro
D’Avila, Joana C.
Prado, Darwin
Madeira, Caroline
Vargas-Lopes, Charles
Panizzutti, Rogerio
Azevedo, Luciano C.P.
Bozza, Fernando A.
author_role author
author2 D’Avila, Joana C.
Prado, Darwin
Madeira, Caroline
Vargas-Lopes, Charles
Panizzutti, Rogerio
Azevedo, Luciano C.P.
Bozza, Fernando A.
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Kurtz, Pedro
D’Avila, Joana C.
Prado, Darwin
Madeira, Caroline
Vargas-Lopes, Charles
Panizzutti, Rogerio
Azevedo, Luciano C.P.
Bozza, Fernando A.
dc.subject.en.pt_BR.fl_str_mv Acute brain dysfunction
Cerebral multimodality monitoring
Sepsis-associated encephalopathy
topic Acute brain dysfunction
Cerebral multimodality monitoring
Sepsis-associated encephalopathy
description 2020-03-01
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-03-29T13:31:15Z
dc.date.available.fl_str_mv 2019-03-29T13:31:15Z
dc.date.issued.fl_str_mv 2019
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv KURTZ, Pedro et al. Cerebral multimodal monitoring in sepsis: an experimental study. Shock, v. 51, n. 2, p. 228-234, 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/32293
dc.identifier.issn.pt_BR.fl_str_mv 1073-2322
dc.identifier.doi.none.fl_str_mv 10.1097/SHK.0000000000001138
dc.identifier.eissn.none.fl_str_mv 1540-0514
identifier_str_mv KURTZ, Pedro et al. Cerebral multimodal monitoring in sepsis: an experimental study. Shock, v. 51, n. 2, p. 228-234, 2019.
1073-2322
10.1097/SHK.0000000000001138
1540-0514
url https://www.arca.fiocruz.br/handle/icict/32293
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Lippincott, Williams & Wilkins
publisher.none.fl_str_mv Lippincott, Williams & Wilkins
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
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collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/32293/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/32293/2/ve_Kurtz_Pedro_etal_INI_2019.pdf
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