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. 2016 Apr-Jun;11(2):151-9.
doi: 10.4103/1793-5482.145375.

Exogenous lactate infusion improved neurocognitive function of patients with mild traumatic brain injury

Tatang Bisri  1 , Billy A Utomo  1 , Iwan Fuadi  1
Affiliations

Exogenous lactate infusion improved neurocognitive function of patients with mild traumatic brain injury

Tatang Bisri et al. Asian J Neurosurg. 2016 Apr-Jun.

Abstract

Background: Many studies showed a better recovery of cognitive function after administration of exogenous lactate during moderate-severe traumatic brain injury. However, the study evaluating lactate effect on mild traumatic brain injury is still limited.

Aims: To evaluate the effect of exogenous lactate on cognitive function in mild traumatic brain injury patients.

Settings and design: Prospective, single blind, randomized controlled study on 60 mild traumatic brain injury patients who were undergoing neurosurgery.

Materials and methods: Subjects were randomly assigned into hyperosmolar sodium lactate (HSL) group or hyperosmolar sodium chloride (HSS) group. Patients in each group received either intravenous infusion of HSL or NaCl 3% at 1.5 ml/KgBW within 15 min before neurosurgery. During the surgery, patients in both groups received maintenance infusion of NaCl 0.9% at 1.5 ml/KgBW/hour.

Statistical analysis: Cognitive function, as assessed by Mini-Mental State Examination (MMSE) score at 24 h, 30 and 90 days post-surgery, was analyzed by Anova repeated measures test.

Results: The MMSE score improvement was significantly better in HSL group than HSS group (P < 0.001). In HSL group the MMSE score improved from 16.00 (13.75-18.00) at baseline to 21.00 (18.75-22.00); 25.00 (23.75-26.00); 28.00 (27.00-29.00) at 24 h, 30, 90 days post-surgery, respectively. In contrast, in HSS group the MMSE score almost unchanged at 24 h and only slightly increased at 30 and 90 days post-surgery.

Conclusions: Hyperosmolar sodium lactate infusion during mild traumatic brain injury improved cognitive function better than sodium chloride 3%.

Keywords: Cognitive function; MMSE Score; mild brain injury; sodium lactate.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Straight line: HSL, dashed line: HSS. Panel (a) MMSE Orientation; (b) Registration; (c) Attention; (d) Recall; (e) Language; (f) Total score. Evaluation was done before surgery, 24 h, 30, and 90 days post-surgery. Comparisons by repeated measure ANOVA
Figure 2
Figure 2
Straight line: HSL, dashed line: HSS. Panel (a) Mean Arterial Pressure (MAP); (b) Heart Rate; (c) Oxygen Saturation, (%). Evaluations were done every 15 min during surgery. Time variable was normalized to deal with the different length of surgery. Comparisons by repeated measure ANOVA; MAP: P =0.311; HR: P =0.9; OS: P =0.116
Figure 3
Figure 3
Straight line: HSL, dashed line: HSS. Panel (a) Sodium; (b) Plasma Osmolality, mOsm/kg BW. Evaluations were done before surgery, 15 min, and 6 h post-surgery. Comparisons by repeated measure ANOVA
See this image and copyright information in PMC

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