Current opinion in anaesthesiology · 2022
Hyperlactatemia and other perioperative metabolic disturbances in neuroanesthesia.
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Klimek Markus, de Smalen Peter, Janssen Joost
Аннотация
PURPOSE OF REVIEW: The concept of 'brain-body cross-talking' has gained growing interest in the last years. The understanding of the metabolic disturbances (e.g., hypernatraemia/hyponatraemia and hyperlactatemia) in neurosurgical patients has improved during the last years.
RECENT FINDINGS: The impact of elevated lactate without acidosis in neurosurgical patients remains controversial. The pathophysiology of inappropriate secretion of antidiuretic hormone (SIADH) has become clearer, whereas the diagnosis of cerebral salt wasting should be used more carefully.
SUMMARY: These findings will contribute to a better understanding of the pathophysiology involved and enable better prevention and therapy where possible in clinical practice.
RECENT FINDINGS: The impact of elevated lactate without acidosis in neurosurgical patients remains controversial. The pathophysiology of inappropriate secretion of antidiuretic hormone (SIADH) has become clearer, whereas the diagnosis of cerebral salt wasting should be used more carefully.
SUMMARY: These findings will contribute to a better understanding of the pathophysiology involved and enable better prevention and therapy where possible in clinical practice.