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dc.contributor.authorRose, Christopher F.
dc.contributor.authorYtrebø, Lars M.
dc.contributor.authorDavies, Nathan
dc.contributor.authorSen, Sambit
dc.contributor.authorNedredal, Geir I.
dc.contributor.authorBélanger, Mireille
dc.contributor.authorJalan, Rajiv
dc.contributor.authorRevhaug, Arthur
dc.date.accessioned2015-03-05T18:48:06Z
dc.date.available2015-03-05T18:48:06Z
dc.date.issued2007-12
dc.identifier.citationRose, C.; Ytrebø, L. M.; Davies, N. A.; Sen, S.; Nedredal, G. I.; Belanger, M.; Revhaug, A. & Jalan, R. Association of reduced extracellular brain ammonia, lactate, and intracranial pressure in pigs with acute liver failure. Hepatology, Dec, 2007, 46(6), 1883-1892fr
dc.identifier.urihttp://hdl.handle.net/1866/11400
dc.subjectAmmoniafr
dc.subjectIntracranial Pressurefr
dc.subjectGlutaminefr
dc.subjectDetoxificationfr
dc.subjectLiver Failurefr
dc.subjectLactatefr
dc.subjectGlutamatefr
dc.subjectAmmoniacfr
dc.subjectPression intracrâniennefr
dc.subjectDéfaillance hépatiquefr
dc.subjectAcide lactiquefr
dc.titleAssociation of reduced extracellular brain ammonia, lactate, and intracranial pressure in pigs with acute liver failure
dc.typeArticlefr
dc.contributor.affiliationUniversité de Montréal. Faculté de médecine. Centre de recherche du CHUMfr
dc.contributor.affiliationUniversité de Montréal. Faculté de médecinefr
dc.identifier.doi10.1002/hep.21877
dcterms.abstractWe previously demonstrated in pigs with acute liver failure (ALF) that albumin dialysis using the molecular adsorbents recirculating system (MARS) attenuated a rise in intracranial pressure (ICP). This was independent of changes in arterial ammonia, cerebral blood flow and inflammation, allowing alternative hypotheses to be tested. The aims of the present study were to determine whether changes in cerebral extracellular ammonia, lactate, glutamine, glutamate, and energy metabolites were associated with the beneficial effects of MARS on ICP. Three randomized groups [sham, ALF (induced by portacaval anastomosis and hepatic artery ligation), and ALF+MARS] were studied over a 6-hour period with a 4-hour MARS treatment given beginning 2 hours after devascularization. Using cerebral microdialysis, the ALF-induced increase in extracellular brain ammonia, lactate, and glutamate was significantly attenuated in the ALF+MARS group as well as the increases in extracellular lactate/pyruvate and lactate/glucose ratios. The percent change in extracellular brain ammonia correlated with the percent change in ICP (r(2) = 0.511). Increases in brain lactate dehydrogenase activity and mitochondrial complex activity for complex IV were found in ALF compared with those in the sham, which was unaffected by MARS treatment. Brain oxygen consumption did not differ among the study groups. Conclusion: The observation that brain oxygen consumption and mitochondrial complex enzyme activity changed in parallel in both ALF- and MARS-treated animals indicates that the attenuation of increased extracellular brain ammonia (and extracellular brain glutamate) in the MARS-treated animals reduces energy demand and increases supply, resulting in attenuation of increased extracellular brain lactate. The mechanism of how MARS reduces extracellular brain ammonia requires further investigation.fr
dcterms.bibliographicCitationHepatology ; 46(6)
dcterms.languageengfr
UdeM.VersionRioxxVersion acceptée / Accepted Manuscript


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