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Cerebral metabolic effects of strict versus conventional glycaemic targets following severe traumatic brain injury.
Plummer MP, Notkina N, Timofeev I, Hutchinson PJ, Finnis ME, Gupta AK. Plummer MP, et al. Crit Care. 2018 Jan 25;22(1):16. doi: 10.1186/s13054-017-1933-5. Crit Care. 2018. PMID: 29368635 Free PMC article. Clinical Trial.

Strict glycaemia increased the frequency of low cerebral glucose (< 0.8 mmol/L; OR 1.91 [95% CI 1.01-3.65]; P < 0.05); however, there were no differences in the frequency of critically low glucose (< 0.2 mmol/L) or critically elevated lactate/pyruvate

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Strict glycaemia increased the frequency of low cerebral glucose (< 0.8 mmol/L; OR 1.91 [95% CI 1.01-3.65]; P < 0.05); however, there

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Intensive insulin therapy reduces microdialysis glucose values without altering glucose utilization or improving the lactate/pyruvate ratio after traumatic brain injury.
Vespa P, Boonyaputthikul R, McArthur DL, Miller C, Etchepare M, Bergsneider M, Glenn T, Martin N, Hovda D. Vespa P, et al. Crit Care Med. 2006 Mar;34(3):850-6. doi: 10.1097/01.CCM.0000201875.12245.6F. Crit Care Med. 2006. PMID: 16505665
However, intensive insulin therapy was associated with increased incidence of microdialysis markers of cellular distress, namely elevated glutamate (38+/-37% vs. 10+/-17%, p<.01), elevated lactate/pyruvate ratio (38+/-37% vs. 19+/-26%, p<.03) and …
However, intensive insulin therapy was associated with increased incidence of microdialysis markers of cellular distress, namely elevated gl …
Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study.
Vespa P, Bergsneider M, Hattori N, Wu HM, Huang SC, Martin NA, Glenn TC, McArthur DL, Hovda DA. Vespa P, et al. J Cereb Blood Flow Metab. 2005 Jun;25(6):763-74. doi: 10.1038/sj.jcbfm.9600073. J Cereb Blood Flow Metab. 2005. PMID: 15716852 Free PMC article. Clinical Trial.
Longitudinal MD data revealed a 25% incidence rate of metabolic crisis (elevated lactate/pyruvate ratio (LPR) > 40) but only a 2.4% incidence rate of ischemia. ...
Longitudinal MD data revealed a 25% incidence rate of metabolic crisis (elevated lactate/pyruvate ratio (LPR) &g …