Metabolic aspects of acute cerebral hypoxia during extracorporeal circulation and their modification induced by acetyl-carnitine treatment.
Following their previous research experiences in human tissue hypoxia, in the present study the authors. investigated the metabolic effects of acute brain hypoxia in a group of patients in course of extracorporeal circulation for aorto-pulmonary bypass. One hundred subjects were treated, half with a placebo and half with acetyl-carnitine to evaluate the effects of oxidative stress in some brain plasmatic metabolites and to verify the effect of acetyl-carnitine on the tissue energy capacity. The levels of lactate, pyruvate, succinate and fumarate showed a significant imbalance due to hypoxia, while the acetyl-carnitine treatment confined the metabolic gradients within physiological limits. This means that during the course of extracorporeal circulation brain hypoxia plays a pathological role assuming the typical picture of cellular oxidative damage and the acetyl-carnitine antagonizes these deleterious effects of hypoxia by a protective mechanism on the energy processes and then on the cellular enzymic activities. In this regard, the d-tyrosine levels, considered as a proteolytic index, confirm the action of acetyl-carnitine on the cell morpho-functional integrity.
Corbucci
G G
GG
Institute of Anaesthesia and Intensive Care, University of Cagliari, Italy.
Menichetti
A
A
Cogliatti
A
A
Nicoli
P
P
Arduini
A
A
Damonti
W
W
Marchionni
A
A
Calvani
M
M
D000108:Acetylcarnitine / Q000627:therapeutic use*; D000208:Acute Disease; D000758:Anesthesia; D002315:Cardiopulmonary Bypass; D004311:Double-Blind Method; D005112:Extracorporeal Circulation; D005650:Fumarates / Q000097:blood; D006019:Glycolysis / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D002534:Hypoxia, Brain / Q000188:drug therapy / Q000378:metabolism*; D007773:Lactates / Q000097:blood; D011773:Pyruvates / Q000097:blood; D013386:Succinates / Q000097:blood; D014443:Tyrosine / Q000097:blood
D005650:Fumarates; D007773:Lactates; D011773:Pyruvates; D013386:Succinates; D014443:Tyrosine; D000108:Acetylcarnitine