{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T23:49:27Z","timestamp":1769298567549,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T00:00:00Z","timestamp":1539734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004196","name":"Odense Universitetshospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006197","name":"Fonden til L\u00e6gevidenskabens Fremme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006197","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Compromised cerebral energy metabolism is common in patients with bacterial meningitis. In this study, simultaneous measurements of cerebral oxygen tension and lactate\/pyruvate ratio were compared to explore whether disturbed energy metabolism was usually caused by insufficient tissue oxygenation or compromised oxidative metabolism of pyruvate indicating mitochondrial dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subject and Methods<\/jats:title><jats:p>Ten consecutive patients with severe streptococcus meningitis were included in this prospective cohort study. Intracranial pressure, brain tissue oxygen tension (PbtO<jats:sub>2<\/jats:sub>), and energy metabolism (intracerebral microdialysis) were continuously monitored in nine patients. A cerebral lactate\/pyruvate (LP) ratio &lt;30 was considered indicating normal oxidative metabolism, LP ratio &gt;30 simultaneously with pyruvate below lower normal level (70\u00a0\u00b5mol\/L) was interpreted as biochemical indication of ischemia, and LP ratio &gt;30 simultaneously with a normal or increased level of pyruvate was interpreted as mitochondrial dysfunction. The biochemical variables were compared with PbtO<jats:sub>2<\/jats:sub> simultaneously monitored within the same cerebral region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In two cases, the LP ratio was normal during the whole study period and the simultaneously monitored PbtO<jats:sub>2<\/jats:sub> was 18\u00a0\u00b1\u00a06\u00a0mm\u00a0Hg. In six cases, interpreted as mitochondrial dysfunction, the simultaneously monitored PbtO<jats:sub>2<\/jats:sub> was 20\u00a0\u00b1\u00a06\u00a0mm\u00a0Hg and without correlation with the LP ratio. In one patient, exhibiting a pattern interpreted as ischemia, PbtO<jats:sub>2<\/jats:sub> decreased below 10\u00a0mm\u00a0Hg and a correlation between LP and PbtO<jats:sub>2<\/jats:sub> was observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated that compromised cerebral energy metabolism, evidenced by increased LP ratio, was common in patients with severe bacterial meningitis while not related to insufficient tissue oxygenation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13278","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T07:57:10Z","timestamp":1539763030000},"page":"329-336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Patterns of cerebral tissue oxygen tension and cytoplasmic redox state in bacterial meningitis"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4113-4182","authenticated-orcid":false,"given":"Lykke","family":"Larsen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Odense University Hospital Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3943-8128","authenticated-orcid":false,"given":"Troels H.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Research University of Southern Denmark Odense Denmark"},{"name":"Department of Neurosurgery Odense University Hospital Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl\u2010Henrik","family":"Nordstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Research University of Southern Denmark Odense 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