title: Effect of ginkgolide B on brain metabolism and tissue oxygenation in severe haemorrhagic stroke.
abstract: Ginkgolide B, a diterpene, is an herbal constituent isolated from the leaves of Ginkgo biloba tree. The present study demonstrates the effect of ginkgolide B in osmotherapy on brain metabolism and tissue oxygenation. Multimodality monitoring including intracranial pressure (ICP), cerebral perfusion pressure (CPP), partial pressure of brain tissue oxygen (PbtO2), lactate/pyruvate ratio (LPR) and microdialysis were employed to study the effect of ginkgolide B osmotherapy. The results demonstrated that administration of 15% solution of ginkgolide B to the comatose patients with raised ICP (> 20 mm Hg) and resistant to standard therapy led to a significant decrease in ICP. The cerebral microdialysis was used to compare mean arterial blood pressure (MAP), ICP, CPP, PbtO2, brain lactate, pyruvate and glucose level after hourly intervals starting 3 h before and up to 4 h after hyperosmolar therapy. There was a decrease in ICP in 45 min from 23 ± 14 mm Hg (P < 0.001) to 18 ± 24 mm Hg and increase in CPP after 1 h of gingkolide B infusion from 74 ± 18 to 85 ± 22 mm Hg (P < 0.002). However there was no significant effect on MAP but PbtO2 was maintained in the range of 22-26. The peak lactate/pyruvate ratio was recorded at the time of initiation of osmotherapy (44 ± 20) with an 18% decrease over 2 h following gingkolide B therapy. Also the brain glucose remained unaffected.
authors.affiliation: Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University Harbin 150001, Heilongjiang, China.
authors.forename: Chun-Ling
authors.initials: CL
authors.lastname: Chi
authors.affiliation: Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University Harbin 150001, Heilongjiang, China.
authors.forename: Dong-Fang
authors.initials: DF
authors.lastname: Shen
authors.affiliation: Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University Harbin 150001, Heilongjiang, China.
authors.forename: Peng-Jun
authors.initials: PJ
authors.lastname: Wang
authors.affiliation: Department of Neurobiology, Harbin Medical University Provincial Key Lab of Neurobiology, Harbin Medical University Harbin 150081, Heilongjiang, China.
authors.forename: Hu-Lun
authors.initials: HL
authors.lastname: Li
authors.affiliation: Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University Harbin 150001, Heilongjiang, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
keywords: Osmotherapy; infusion; intracranial pressure; microdialysis; perfusion pressure