Circulation, Vol 51, 701-712, Copyright © 1975 by American Heart Association
JS Meyer, Y Itoh, S Okamoto, KM Welch, NT Mathew, EO Ott, S Sakaki, Y Miyakawa, E Chabi and AD Ericsson
The effect of intravenous infusion of 10 per cent glycerol on regional
cerebral blood flow (using hydrogen bolus and Xenon-133 (133Xe) clearance
methods) and metabolism was investigated in 57 patients with recent
cerebral infarction. Hemispheric blood flow (HBF) increased, together with
increase in regional cerebral blood flow (rCBF) and cerebral blood volume
(rCBV), in foci of brain ischemia. Hemispheric oxygen consumption (HMIO2)
decreased together with hemispheric respiratory quotient. Systemic blood
levels of glucose, lactate, pyruvate, and triglycerides also increased
after glycerol while free fatty acids (FFA) and inorganic phosphate (Pi)
decreased. Hemispheric glucose consumption was unaltered after glycerol so
that hemispheric glucose to oxygen ratio tended to rise. Pyruvate and
lactate production by brain was unchanged. Glycerol moved across the blood
brain barrier into brain and cerebrospinal fluid (CSF). Release of FFA and
Pi from infarcted brain was reversed by glycerol. Total phosphate balance
was maintained actoss brain both before and after glycerol infusion.
Triglycerides increased in CSF after glycerol, originating either from
cerebral blood or as a result of lipogenesis in cerebral tissue. The EEG
Recording and neurological status of the patients improved despite
decreased brain oxygen consumption. Results of this study suggest that
after intravenous infusion of 10 per cent glycerol in patients with recent
cerebral infarction, glycerol rapidly enters the CSF and brain compartments
and favorably affects the stroke process in two ways: first, by
redistribution of cerebral blood flow with increase in rCBF and rCBV in
ischemic brain secondary to reduction in focal cerebral edema; and second
glycerol may become an alternative source of energy either by being
directly metabolized by the brain, or indirectly, by enhancing lipogenesis,
or by both processes. Involvement of glycerol in lipogenesis with
esterification to accumulated FFA might lead to improved coupling of
oxidative phosphorylation, a hypothesis that fits the finding of improved
neuronal function despite further decrease in cerebral hemispheric oxygen
consumption.
ARTICLES
Circulatory and metabolic effects of glycerol infusion in patients with recent cerebral infarction
This article has been cited by other articles:
 |
|
 |
|
  J. Bardutzky and S. Schwab Antiedema Therapy in Ischemic Stroke Stroke, November 1, 2007; 38(11): 3084 - 3094. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Berger, O. W. Sakowitz, K. L. Kiening, and S. Schwab Neurochemical Monitoring of Glycerol Therapy in Patients With Ischemic Brain Edema Stroke, February 1, 2005; 36(2): e4 - e6. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Shuaib, C. Xu Wang, T. Yang, and R. Noor Effects of Nonpeptide V1 Vasopressin Receptor Antagonist SR-49059 on Infarction Volume and Recovery of Function in a Focal Embolic Stroke Model Stroke, December 1, 2002; 33(12): 3033 - 3037. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Aoki, M. Tamura, Y. Itoh, T. Seto, K. Nonaka, H. Mukai, and Y. Ukai Effective Plasma Concentration of a Novel Na+/Ca2+ Channel Blocker NS-7 for Its Cerebroprotective Actions in Rats with a Transient Middle Cerebral Artery Occlusion J. Pharmacol. Exp. Ther., April 13, 2001; 296(2): 306 - 311. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. Fujishima, T. Ishitsuka, F. Yoshida, S. Ibayashi, O. Shiokawa, and S. Sadoshima Effects of Intravenous Glycerol on Cerebral Blood Flow and Tissue Metabolism in Acute Cerebral Ischemia in Spontaneously Hypertensive Rats Angiology, February 1, 1986; 37(2): 92 - 98. [Abstract] [PDF]
|
|