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One aspect of DCR is permissive hypotension. However, the duration of hypotension that can be tolerated without affecting the brain is unknown. In the present study we investigate the effect of 60\u2009min severe hypotension on the brain\u2019s energy metabolism and seek to verify earlier findings that venous cerebral blood can be used as a marker of global cerebral energy state.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and methods<\/jats:title>\n                <jats:p>Ten pigs were anaesthetized, and vital parameters recorded. Microdialysis catheters were placed in the left parietal lobe, femoral artery, and superior sagittal sinus for analysis of lactate, pyruvate, glucose, glycerol, and glutamate. Hemorrhagic shock was induced by bleeding the animal until mean arterial pressure (MAP) of 40\u2009mmHg was achieved. After 60\u2009min the pigs were resuscitated with autologous blood and observed for 3\u2009h.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>At baseline the lactate to pyruvate ratios (LP ratio) in the hemisphere, artery, and sagittal sinus were (median (interquartile range)) 13 (8\u201316), 21 (18\u201324), and 9 (6\u201322), respectively. After induction of hemorrhagic shock, the LP ratio from the left hemisphere in 9 pigs increased to levels indicating a reversible perturbation of cerebral energy metabolism 19 (12\u201330). The same pattern was seen in LP measurements from the femoral artery 28 (20\u201335) and sagittal sinus 22 (19\u201326). At the end of the experiment hemisphere, artery and sinus LP ratios were 16 (10\u201323), 17 (15\u201325), and 17 (10\u201327), respectively. Although hemisphere and sinus LP ratios decreased, they did not reach baseline levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In one pig hemisphere LP ratio increased to a level indicating irreversible metabolic perturbation (LP ratio &gt;\u2009200).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>During 60\u2009min of severe hypotension intracerebral microdialysis shows signs of perturbations of cerebral energy metabolism, and these changes trend towards baseline values after resuscitation. Sagittal sinus microdialysis values followed hemisphere values but were not distinguishable from systemic arterial values. Venous (jugular bulb) microdialysis might have a place in monitoring conditions where global cerebral ischemia is a risk.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40635-019-0282-x","type":"journal-article","created":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T20:02:37Z","timestamp":1575489757000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Moderately prolonged permissive hypotension results in reversible metabolic perturbation evaluated by intracerebral microdialysis - an experimental animal study"],"prefix":"10.1186","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9114-2236","authenticated-orcid":false,"given":"Rasmus Peter","family":"Jakobsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troels Halfeld","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"M\u00f8lstr\u00f8m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl-Henrik","family":"Nordstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asger","family":"Granfeldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palle","family":"Toft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"issue":"7","key":"282_CR1","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1007\/s00268-007-9087-2","volume":"31","author":"C. 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