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The purpose of this study was to determine the sensitivity, specificity, and predictive value of AVDL as an indicator of increases in brain lactate production in patients with TBIs.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Arteriojugular venous differences of lactate were calculated every 6 hours using samples obtained though a catheter placed in the jugular bulb in 45 patients with diffuse head injuries (57.8%) or evacuated brain lesions (42.2%). Cerebral lactate concentration obtained with a 20-kD microdialysis catheter implanted in undamaged tissue was used as the de facto gold standard.<\/jats:p>\n<jats:p>Six hundred seventy-three AVDL determinations and cerebral microdialysis samples were obtained simultaneously; 543 microdialysis samples (81%) showed lactate values greater than 2 mmol\/L, but only 21 AVDL determinations (3.1%) showed an increase in brain lactate. No correlation was found between AVDL and cerebral lactate concentration (\u03c1 = 0.014, p = 0.719). Arteriojugular venous differences of lactate had a sensitivity and specificity of 3.3 and 97.7%, respectively, with a false-negative rate of 96.7% and a false-positive rate of 2.3%.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Arteriojugular venous differences of lactate do not reliably reflect increased cerebral lactate production and consequently are not reliable in ruling out brain ischemia in patients with TBIs. The clinical use of this monitoring method in neurocritical care should be reconsidered.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns.2007.106.4.530","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:50:27Z","timestamp":1201179027000},"page":"530-537","source":"Crossref","is-referenced-by-count":19,"title":["Lack of utility of arteriojugular venous differences of lactate as a reliable indicator of increased brain anaerobic metabolism in traumatic brain injury"],"prefix":"10.3171","volume":"106","author":[{"given":"Maria A.","family":"Poca","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Neurotraumatology Research Unit, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Sahuquillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Neurotraumatology Research Unit, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Vilalta","sequence":"additional","affiliation":[{"name":"Neurotraumatology Research Unit, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Garnacho","sequence":"additional","affiliation":[{"name":"Neurotraumatology Research Unit, and"},{"name":"Neurotraumatology Intensive Care Unit, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute, Autonomous University of Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1060530","series-title":"Brain Res Rev","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/S0165-0173(00)00038-2","article-title":"CNS energy metabolism as related to function","volume":"34","author":"Ames","year":"2000"},{"key":"b2-1060530","series-title":"J Neurotrauma","first-page":"457","article-title":"The Brain Trauma Foundation. 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