{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:16:37Z","timestamp":1780046197158,"version":"3.53.1"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Oberstinde Kirsten Jensa la Cours legat"},{"name":"Hakon August Valdbj\u00f8rn, Else Valdbj\u00f8rn og Hugo Valdbj\u00f8rns Fond"},{"name":"Jens og Maren Thestrups Legat til kr\u00e6ftforskning"},{"DOI":"10.13039\/501100009498","name":"L\u00e6ge Agnethe L\u00f8vgreens Legat","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009498","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>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 Arterial blood samples for lactate and glucose measurement will be withdrawn hourly during surgery and until six hours postoperatively.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.<\/jats:p>","DOI":"10.1371\/journal.pone.0271682","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T17:44:08Z","timestamp":1658425448000},"page":"e0271682","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hyperlactatemia associated with elective tumor craniotomy: Protocol for an observational study of pathophysiology and clinical implications"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9476-5850","authenticated-orcid":true,"given":"Alexandra","family":"Vassilieva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3058-1072","authenticated-orcid":true,"given":"Kirsten","family":"M\u00f8ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Skj\u00f8th-Rasmussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Kryspin","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"key":"pone.0271682.ref001","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.mito.2014.05.007","article-title":"Comprehensive review on lactate metabolism in human health","volume":"17","author":"M Adeva-Andany","year":"2014","journal-title":"Mitochondrion"},{"issue":"5","key":"pone.0271682.ref002","first-page":"446","volume":"9","author":"GA Brooks","year":"2020","journal-title":"Sep"},{"issue":"6","key":"pone.0271682.ref003","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1177\/1944451611424486","article-title":"Frequency and Outcomes of Hyperlactatemia After Neurosurgery: A Retrospective Analysis","volume":"2","author":"R Kohli-Seth","year":"2011","journal-title":"ICU Dir"},{"key":"pone.0271682.ref004","first-page":"224","article-title":"Intraoperative serum lactate is not a predictor of survival after glioblastoma surgery","volume":"43","author":"JP Cata","year":"2017","journal-title":"J Clin Neurosci Off J Neurosurg Soc Australas"},{"issue":"1","key":"pone.0271682.ref005","first-page":"1","article-title":"Early postoperative hyperlactatemia in elective neurosurgical patients: A retrospective study","volume":"45","author":"H Yoshikawa","year":"2018","journal-title":"J Saitama Med Univ"},{"issue":"4","key":"pone.0271682.ref006","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/ANA.0000000000000332","article-title":"Elevated Intraoperative Serum Lactate During Craniotomy Is Associated With New Neurological Deficit and Longer Length of Stay","volume":"29","author":"JW Brallier","year":"2017","journal-title":"J Neurosurg Anesthesiol"},{"issue":"1","key":"pone.0271682.ref007","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/ANA.0000000000000594","article-title":"Hyperlactatemia After Intracranial Tumor Surgery Does Not Affect 6-Month Survival: A Retrospective Case Series","volume":"32","author":"PP de Smalen","year":"2020","journal-title":"J Neurosurg Anesthesiol"},{"issue":"10","key":"pone.0271682.ref008","doi-asserted-by":"crossref","first-page":"e0224016","DOI":"10.1371\/journal.pone.0224016","article-title":"Clinical impact of intraoperative hyperlactatemia during craniotomy","volume":"14","author":"D Romano","year":"2019","journal-title":"PLoS One"},{"issue":"22","key":"pone.0271682.ref009","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1056\/NEJM199211263272204","article-title":"A controlled clinical trial of dichloroacetate for treatment of lactic acidosis in adults. 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