Hyperlactatemia associated with elective tumor craniotomy: Protocol for an observational study of pathophysiology and clinical implications
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Hyperlactatemia occurs frequently after brain tumor surgery. Existing studies are scarce and predominantly retrospective, reporting inconsistent associations to new neurological deficits and prolonged hospital stay. Here we describe a protocol for a prospective observational study of hyperlactatemia during and after elective tumor craniotomy and the association with postoperative outcome, as well as selected pathophysiological aspects, and possible risk factors. We will include 450 brain tumor patients scheduled for elective craniotomy. Arterial blood samples for lactate and glucose measurement will be withdrawn hourly during surgery and until six hours postoperatively. To further explore the association of hyperlactatemia with perioperative insulin resistance, additional blood sampling measuring markers of insulin resistance will be done in 100 patients. Furthermore, in a subgroup of 20 patients, blood from a jugular bulb catheter will be drawn simultaneously with blood from the radial artery to measure the arterial to jugular venous concentration difference of lactate, in order to study the direction of cerebrovascular lactate flux. Functional clinical outcome will be determined by the modified Rankin Scale, length of stay and mortality at 30 days, 6 months, 1 year and 5 years. Clinical outcome will be compared between patients with and without hyperlactatemia. Multivariate logistic regression will be used to identify risk factors for hyperlactatemia. A statistical analysis plan will be publicized to support transparency and reproducibility. Results will be published in a peer-reviewed journal and presented at international conferences.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | e0271682 |
| Tidsskrift | PLoS ONE |
| Vol/bind | 17 |
| Udgave nummer | 7 |
| Antal sider | 11 |
| ISSN | 1932-6203 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Alexandra Vassilieva has received funding from the following private foundation: 70.000 DDK from “Oberstinde Kirsten Jensa la Cours legat”, 75.000 DDK from”Jens og Maren Thestrups Legat til kræftforskning” of and 25.000 DDk from “Agnethe Løvgreens Fond”. None of these foundations provided a grant number or played a role in study design, preparation of protocol, data collection and analysis or decision to publish. The Department of Neuroanaesthesiology at Rigshospitalet, Denmark has received payment for performing quality control studies for Radiometer. Radiometer has had no influence on the use of this money and has not initiated or contributed to the design of this protocol. URL of each funder website: Oberstinde Kirsten Jensa la Cours legat: http://www.dasaim.dk/forskning/ansogninger-tildasaims-fond-og-oberstinde-jensa-la-cours-legat/ Jens og Maren Thestrups Legat til kræftforskning: https://www.legatbogen.dk/jens-og-marenthestrups-legat-til-krftforskning/stoetteomraade/ 6307 Agnethe Løvgreens Fond https://www.kvindeligelaeger.dk/om-legatet This does not alter our adherence to PLOS ONE policies on sharing data and materials. We thank Niels Risør Hammer (Department of Neuroanaesthesiology, Rigshospitalet) and Morten Ziebell (Department of Neurosurgery, Rigshospitalet) for supporting this research project with department resources. We also wish to thank Signe Tellerup Nielsen (Department of Anaesthesia, Bispebjerg Hospital) and Rikke Krogh-Madsen (Center for Physical Activity Research, Rigshospitalet) for insightful discussions concerning insulin resistance in planning of sub-study III.
Publisher Copyright:
© 2022 Vassilieva et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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