{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T12:42:45Z","timestamp":1760100165678},"reference-count":37,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1991,1]]},"abstract":"\u2713 The metabolic brain acidosis after trauma has been thought to be harmful and to contribute to neurological deterioration. Amelioration of the brain acidosis either by systemic buffering agents or by hyperventilation has been proposed as a method of treatment. The objective of this study was to explore with magnetic resonance (MR) spectroscopy the metabolic changes in brain that occur with the use of hyperventilation, THAM (tromethamine; tris[hydroxymethyl]aminomethane), and a combination (THAM and hyperventilation) therapy in experimental fluid-percussion injury.<\/jats:p>\nBrain lactate, brain pH, inorganic phosphate (Pi), and adenosine triphosphate levels were measured by 1<\/jats:sup>H and 31<\/jats:sup>P MR spectroscopy. Arterial and cerebrovenous lactate and water content in brain tissue was determined in 29 cats using the specific gravimetric technique. Following injury, the phosphocreatine (PCr)\/Pi ratio, which is an index of cerebral energy depletion, decreased to 76% in four untreated animals, to 79% in 11 THAM-treated animals, to 68% in seven animals receiving hyperventilation, and to 66% in seven animals with combination THAM and hyperventilation therapy. The PCr\/Pi ratio returned to a normal level in 8 hours in animals treated with THAM and THAM in combination with hyperventilation. The brain lactate index increased to 157% in the hyperventilation group after trauma. In cats receiving THAM plus hyperventilation, the brain lactate index was reduced to 142%, while the minimum rise of 126% was associated with treatment of THAM alone. In the THAM-treatment and combination-treatment groups, the water content of the white and gray matter was significantly decreased compared with that in untreated cat brains.<\/jats:p>\nProlonged hyperventilation provided relative ischemia in brain tissue and promoted more production of brain lactate, no recovery of the PCr\/Pi ratio, and no decrease in brain edema. On the other hand, administration of THAM decreased production of brain lactate and brain edema and promoted the recovery of cerebral energy dysfunction. It was found that THAM ameliorates the deleterious effects of hyperventilation by minimizing energy disturbance and that it also decreases brain edema. The authors conclude that THAM may be effective in reducing brain tissue acidosis and helpful as a metabolic stabilizing agent following severe head injury.<\/jats:p>","DOI":"10.3171\/jns.1991.74.1.0087","type":"journal-article","created":{"date-parts":[[2009,5,19]],"date-time":"2009-05-19T16:21:59Z","timestamp":1242750119000},"page":"87-96","source":"Crossref","is-referenced-by-count":45,"title":["Effects of tromethamine and hyperventilation on brain injury in the cat"],"prefix":"10.3171","volume":"74","author":[{"given":"Kazuo","family":"Yoshida","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Marmarou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Intracranial Pressure III.","first-page":"219","article-title":"The effect of THAM on acute intracranial hypertension. An experimental and clinical study","author":"Akioka","year":"1976"},{"key":"b2","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1161\/01.STR.18.3.649","article-title":"Cerebral effects of extended hyperventilation in unanesthetized goats.","volume":"18","author":"Albrecht","year":"1987"},{"key":"b3","series-title":"J Appl Physiol","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1152\/jappl.1968.24.1.66","article-title":"Cerebral carbohydrate metabolism of man during respiratory and metabolic alkalosis.","volume":"24","author":"Alexander","year":"1968"},{"key":"b4","series-title":"J Cereb Blood Flow Metab","first-page":"386","article-title":"Energy compartmentalization in neural tissue.","volume":"9","author":"Andersen","year":"1989"},{"key":"b5","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"601","DOI":"10.3171\/jns.1988.68.4.0601","article-title":"Effect of posttraumatic hypoventilation on cerebral energy metabolism.","volume":"68","author":"Andersen","year":"1988"},{"key":"b6","series-title":"Central Nervous System Trauma. Status Report 1985.","first-page":"229","article-title":"Brain acidosis in head injury: a clinical trial","author":"Becker","year":"1985"},{"key":"b7","series-title":"Eur Neurol","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1159\/000114569","article-title":"Serial CSF lactated\/pyruvate values as a guide to prognosis in head injury coma.","volume":"8","author":"Crockard","year":"1972"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"615","DOI":"10.3171\/jns.1986.65.5.0615","article-title":"Prognostic significance of ventricular CSF lactate acidosis in severe head injury.","volume":"65","author":"DeSalles","year":"1986"},{"key":"b9","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1097\/00000542-196201000-00008","article-title":"Experimental correction of hypercapnic intracranial hypertension.","volume":"23","author":"Dos","year":"1962"},{"key":"b10","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"607","DOI":"10.3171\/jns.1981.54.5.0607","article-title":"Oxidative metabolic activity of cerebral cortex after fluid-percussion head injury in the cat.","volume":"54","author":"Duckrow","year":"1981"},{"key":"b11","series-title":"Clin Neurol Neurosurg","first-page":"213","article-title":"Cerebrospinal fluid lactate and pH in patients with acute severe head injury.","volume":"80","author":"Enevoldsen","year":"1977"},{"key":"b12","series-title":"Intracranial Pressure IV.","first-page":"664","article-title":"Effect of THAM on ICP, EEG and tissue edema parameters in experimental and clinical brain edema","author":"Gaab","year":"1980"},{"key":"b13","series-title":"Surg Gynecol Obstet","first-page":"724","article-title":"Anuria of hypovolemic shock relieved by tris-(hydroxymethyl)aminomethane (THAM).","volume":"112","author":"Goetz","year":"1961"},{"key":"b14","series-title":"Acta Anaesthesiol Scand","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/j.1399-6576.1971.tb05462.x","article-title":"Some correlations between the clinical outcome and the acid-base status of blood and cerebrospinal fluid in patients with traumatic brain injury.","volume":"15","author":"Gordon","year":"1971"},{"key":"b15","series-title":"Acta Anesthesiol Scand","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1111\/j.1399-6576.1970.tb00763.x","article-title":"Further studies on cerebrospinal fluid acid-base status in patients with brain lesions.","volume":"14","author":"Gordon","year":"1970"},{"key":"b16","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"736","DOI":"10.3171\/jns.1988.69.5.0736","article-title":"Production and clearance of lactate from brain tissue, cerebrospinal fluid, and serum following experimental brain injury.","volume":"69","author":"Inao","year":"1988"},{"key":"b17","series-title":"Head Injury.","first-page":"254","article-title":"Spinal fluid lactic acid levels in acute cerebral injury","author":"Kurze","year":"1966"},{"key":"b18","series-title":"Curr Top Cell Regul","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/B978-0-12-152805-8.50007-1","article-title":"Phosphofructokinase.","volume":"5","author":"Mansour","year":"1972"},{"key":"b19","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"530","DOI":"10.3171\/jns.1978.49.4.0530","article-title":"A simple gravimetric technique for measurement of cerebral edema.","volume":"49","author":"Marmarou","year":"1978"},{"key":"b20","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"246","DOI":"10.3171\/jns.1982.56.2.0246","article-title":"An improved gravimetric measure of cerebral edema.","volume":"56","author":"Marmarou","year":"1982"},{"key":"b21","series-title":"Adv Neurol","first-page":"195","article-title":"An unitary theory of causation of anoxic and hypoxic brain pathology.","volume":"26","author":"Meyers","year":"1979"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"923","DOI":"10.3171\/jns.1988.69.6.0923","article-title":"Pial arteriolar vessel diameter and CO2 reactivity during prolonged hyperventilation in the rabbit.","volume":"69","author":"Muizelaar","year":"1988"},{"key":"b23","series-title":"Clin Pharmacol Ther","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1002\/cpt196346784","article-title":"The clinical pharmacology of THAM [tris-(hydromethyl)aminomethane].","volume":"4","author":"Nahas","year":"1963"},{"key":"b24","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1161\/01.STR.3.5.566","article-title":"Hyperventilation and cerebral blood flow.","volume":"3","author":"Raichle","year":"1972"},{"key":"b25","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1001\/archneur.1970.00480290014002","article-title":"Cerebral blood flow during and after hyperventilation.","volume":"23","author":"Raichle","year":"1970"},{"key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"961","DOI":"10.3171\/jns.1984.60.5.0961","article-title":"Experimental brain injury: successful therapy with the weak base, tromethamine. With an overview of CNS acidosis.","volume":"60","author":"Rosner","year":"1984"},{"key":"b27","series-title":"J Neurosurg Sci","first-page":"265","article-title":"Role of automatic ventilation in treatment of severe head injuries.","volume":"17","author":"Rossanda","year":"1973"},{"key":"b28","series-title":"Acta Neurol","first-page":"211","article-title":"The prognostic and therapeutic importance of changes in the CSF during the acute stage of brain injury.","volume":"38","author":"Seitz","year":"1977"},{"key":"b29","series-title":"J Cereb Blood Flow Metab","first-page":"39","article-title":"Glial swelling by lactacidosis in vitro.","volume":"9","author":"Staub","year":"1989"},{"key":"b30","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"520","DOI":"10.3171\/jns.1976.45.5.0520","article-title":"Fluid-percussion model of mechanical brain injury in the cat.","volume":"45","author":"Sullivan","year":"1976"},{"key":"b31","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"594","DOI":"10.3171\/jns.1988.68.4.0594","article-title":"Cerebral energy metabolism following fluid-percussion brain injury in cats.","volume":"68","author":"Unterberg","year":"1988"},{"key":"b32","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1002\/mrm.1910100204","article-title":"1H and 31P NMR measurement of cerebral lactate, high-energy phosphate levels, and pH in humans during voluntary hyperventilation: associated EEG, capnographic, and Doppler findings.","volume":"10","author":"Van Rijen","year":"1989"},{"key":"b33","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1038\/jcbfm.1987.106","article-title":"Effects of traumatic brain injury on cerebral high-energy phosphate and pH: a 31P magnetic resonance spectroscopy study.","volume":"7","author":"Vink","year":"1987"},{"key":"b34","series-title":"Intracranial Pressure VII.","first-page":"630","article-title":"Effect of prophylactic hyperventilation on outcome in patients with severe head injury","author":"Ward","year":"1989"},{"key":"b35","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"617","DOI":"10.3171\/jns.1985.63.4.0617","article-title":"Regional brain metabolite levels following mild experimental head injury in the cat.","volume":"63","author":"Yang","year":"1985"},{"key":"b36","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"498","DOI":"10.3171\/jns.1970.33.5.0498","article-title":"Cerebral acid-base and gas metabolism in brain injury.","volume":"33","author":"Zupping","year":"1970"},{"key":"b37","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1001\/archneur.1971.00490010043006","article-title":"Cerebrospinal fluid metabolic acidosis and brain oxygen supply. Studies in patients with brain infarction.","volume":"25","author":"Zupping","year":"1971"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/74\/1\/article-p87.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/74\/1\/article-p87.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/74\/1\/article-p87.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T20:13:09Z","timestamp":1679861589000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/74\/1\/article-p87.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,1]]},"references-count":37,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/jns.1991.74.1.0087","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1991,1]]}}}