Cerebral Oxygen, Glucose, Lactate, and Pyruvate Metabolism in Stroke
Cerebral blood flow, oxygen, glucose, lactate, and pyruvate metabolism were measured in 13 subjects with completed stroke. Cerebral blood flow and oxygen consumption were reduced, glucose consumption and pyruvate production were normal, and lactate production was increased, suggesting a shift from aerobic to anaerobic cerebral glycolysis.
To test this hypothesis, cerebral blood flow and oxygen delivery were decreased by hyperventilation and increased by inhalation of 5% CO2 in air. Hyperventilation decreased cerebral oxygen consumption (CMRO2) and increased cerebral lactate production. Inhalation of 5% CO2 in air increased cerebral blood flow and oxygen delivery and increased both glucose and oxygen consumption. Relationships between reduction in PaCO2 and cerebral venous PO2 and increased cerebral lactate production were found.
Increasing cerebral blood flow by 5% CO2 inhalation improved circulation and oxygen delivery to ischemic cerebral areas and improved oxygen and glucose metabolism in the majority of cases since these procedures do not alter CMRO2 in normal persons. Intravenous injection of glucose increased cerebral glucose uptake but insulin did not.
- Stroke treatment
- Cerebral ischemia
- Five per cent CO2 plus air
- Cerebral glucose consumption
- Cerebral metabolism
- Cerebral lactate production
- Cerebral vasodilator agents
- Cerebral anaerobic glycolysis
- Cerebral oxygen consumption
- © 1968 American Heart Association, Inc.