Evaluation of hypoxic brain injury with spinal fluid enzymes, lactate, and pyruvate

Kärkelä, J.; Pasanen, Matti; Kaukinen, S.; Mörsky, Pertti; Harmoinen, Aimo

doi:10.1097/00003246-199203000-00015

Cited by 59 publications

(17 citation statements)

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“…Several techniques for the separation and assay of creatine kinase isoenzymes are available (Halonen et al 1982;Wevers et al 1984). The CK-BB isoenzyme determination is well documented in human patients with intracranial tumors and acute cerebral infarctions (Matias-Guiu et al 1986), in hypoxic brain injury after cardiac arrest (Kärkelä et al 1992), as well as in neonates with neurologic disorders (De Praeter et al 1991). The brain isoenzyme efficacy is obvious in diagnosis of brain insult (Osuna et al 1992), because CK-BB activity is an early indicator of brain damage and its level may reflect the extent of cerebral damage (Anagnostopoulos et al 1988).…”

Section: Discussionmentioning

confidence: 99%

Changes in the Creatine Kinase and Lactate Dehydrogenase Activities in Cerebrospinal Fluid of Dogs with Thoracolumbar Disc Disease

Nečas¹,

Sedláková²

1999

Acta Vet. Brno

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Ninety-seven dogs (49 males and 48 females) with thoracolumbar (TL) disc disease which were treated at the Clinic of Surgery and Orthopedics at University of Veterinary and Pharmaceutical Sciences in Brno from October 1997 till the end of December 1998 were included in this study. A total of 142 cerebrospinal fluid (CSF) samples were evaluated. CSF from the cisterna magna (cisterna cerebellomedularis) was collected successfully in all 97 animals. Only 45 samples were obtained from lumbar subarachnoid space in the same patients. The purpose of our study was to determine whether transverse myelopathy due to TL disc protrusion/extrusion may cause elevation of CSF creatine kinase (CK) and lactate dehydrogenase (LDH) activities in dogs. Normal values of CSF CK (0.41 ± 0.43 µkat/l) and LDH (0.40 ± 0.28 µkat/l) activities were determined in 23 healthy dogs. The highest normal enzyme activity was assessed as s ͬ0.95 (mean + 2 SD). Activity of CSF CK 1.27 µkat/l, and activity of CSF LDH 0.96 µkat/l were considered to be abnormal. Significant differences (Mann-Whitney U-test; p < 0.01) between activities of the two enzymes in the cerebrospinal fluid of healthy dogs and dogs with TL disc extrusion (the mean CSF CK = 2.47 ± 3.22 µkat/l; the mean CSF LDH = 1.45 ± 1.98 µkat/l) were found. CSF from lumbar and atlantooccipital punctures in 45 patients, in which both the samples were successfuly collected, were analyzed and compared statistically. The mean CK activity of the lumbar CSF samples was 2.47 ± 3.22 µkat/l; the mean CK concentration of atlantooccipital CSF was 0.50 ± 0.47 µkat/l. The mean of lumbar CSF LDH activities was 1.45 ± 1.98 µkat/l; the mean of atlantooccipital CSF LDH values was 0.34 ± 0.32 µkat/l. Statistical analysis (Wilcoxon matched-pairs signed-ranks test) indicated that differences in the CK and LDH concentrations between CSF samples obtained from the cisterna magna, and from lumbar subarachnoid space were significant (p < 0.01). The dynamics of CSF CK and LDH activities in dogs with disc disease was assessed, as well. The mean of CSF CK activity taken on the first day of paraparesis/paraplegia was 1.47 ± 1.22 µkat/l. Creatine kinase in the cerebrospinal fluid had peaked at 48 hours after onset of clinical signs (3.84 ± 4.95 µkat/l). On the third and fourth days its activity had significantly decreased (p < 0.01) to 1.76 ± 2.71 µkat/l. A second peak was identified (p < 0.05) between day seven and seventeen (3.80 ± 3.23 µkat/l). The mean LDH concentration in the CSF on day one was 1.32 ± 1.28 µkat/l, but its concentration increased significantly (p < 0.01) during the second day of clinical signs (2.36 ± 3.38 µkat/l). Mean LDH concentration decreased significantly (p < 0.01) on the third and the fourth days (0.80 ± 0.33 µkat/l) without a second peak of activity.

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Section: Discussionmentioning

confidence: 99%

Changes in the Creatine Kinase and Lactate Dehydrogenase Activities in Cerebrospinal Fluid of Dogs with Thoracolumbar Disc Disease

Nečas¹,

Sedláková²

1999

Acta Vet. Brno

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“…934 Cerebrospinal fluid levels of ␤-d-N-acetylglucosaminidase and pyruvate were not associated with the prognosis of cardiac arrest (LOE P2). 934 …”

Section: Biochemical Markers Als-pa-052a Als-pa-052bmentioning

confidence: 97%

“…931 However, other studies found no relationship between outcome and serum IL-8 (LOE P1), 923 and procalcitonin and sTREM-1 (LOE P3). 932 Worse outcomes for comatose survivors of cardiac arrest are also associated with increased levels of cerebrospinal fluid (CSF)-CK (LOE P2) 933,934 and cerebrospinal fluid-CKBB (LOE P1 905,906 ; LOE P2 908,919,934,935 ; LOE P3 936 -938 ). However, 1 study found no relationship between cerebrospinal fluid-CKBB and prognosis (LOE P2).…”

Section: Biochemical Markers Als-pa-052a Als-pa-052bmentioning

confidence: 99%

“…However, 1 study found no relationship between cerebrospinal fluid-CKBB and prognosis (LOE P2). 939 Outcomes are also associated with increased cerebrospinal fluid levels of other markers including NSE (LOE P1 906 ; LOE P2 915,919 ); S100 (LOE P2) 915 LDH, GOT(LOE P2) 908,934 ; neurofilament (LOE P3) 940 ; and acid phosphatase and lactate (LOE P2). 934 Cerebrospinal fluid levels of ␤-d-N-acetylglucosaminidase and pyruvate were not associated with the prognosis of cardiac arrest (LOE P2).…”

Section: Biochemical Markers Als-pa-052a Als-pa-052bmentioning

confidence: 99%

See 1 more Smart Citation

Part 8: Advanced Life Support

Morrison¹,

Deakin²,

Morley³

et al. 2010

Circulation

411

169

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“…Whether this is a cause or effect of delirium, or indeed a measure of how unwell the delirious patients are compared to controls, is unclear. Lactate is produced during ischaemia, when the lack of oxygen necessitates the switching of glycolytic metabolism from aerobic to anaerobic [40,41] , and high levels have also Color version available online been found in CSF in dementia [42] and after out of hospital cardiac arrest [41] . The finding of low neuronspecific enolase (a glycolytic enzyme released following neuronal cell damage) was surprising, and the investigators suspect it to be due to lactate suppressing NSE -possibly via glutamate stimulation suppressing glycolysis in neurons, which instead gain energy from astrocytic lactate, as described in the astrocyte-neuron-lactate shuttle hypothesis [43] .…”

Section: Direct Brain Insultsmentioning

confidence: 99%

A Systematic Literature Review of Cerebrospinal Fluid Biomarkers in Delirium

Hall¹,

Shenkin²,

MacLullich³

2011

Dement Geriatr Cogn Disord

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Background: Cerebrospinal fluid (CSF) analysis has great potential to advance understanding of delirium pathophysiology. Methods: A systematic literature review of CSF studies of DSM or ICD delirium was performed. Results: In 8 studies of 235 patients, delirium was associated with: elevated serotonin metabolites, interleukin-8, cortisol, lactate and protein, and reduced somatostatin, β-endorphin and neuron-specific enolase. Elevated acetylcholinesterase predicted poor outcome after delirium and higher dopamine metabolites were associated with psychotic features. Conclusions: No clear conclusions emerged, but the current literature suggests multiple areas for further investigation with more detailed studies.

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Evaluation of hypoxic brain injury with spinal fluid enzymes, lactate, and pyruvate

Cited by 59 publications

References 0 publications

Changes in the Creatine Kinase and Lactate Dehydrogenase Activities in Cerebrospinal Fluid of Dogs with Thoracolumbar Disc Disease

Changes in the Creatine Kinase and Lactate Dehydrogenase Activities in Cerebrospinal Fluid of Dogs with Thoracolumbar Disc Disease

Part 8: Advanced Life Support

A Systematic Literature Review of Cerebrospinal Fluid Biomarkers in Delirium

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