Effect of Exogenous Lactate on Neurocognitive in Brain Trauma
Condition: Traumatic Brain Injury
MeSH terms: Brain Injuries; Brain Injuries, Traumatic
Study type: Interventional

Summary: 
      Mild traumatic brain injury (TBI) is the most common type of brain injury. Post-mild TBI
      disability could stem from cognitive, physical, psychological and social dysfunction which
      resulted in significant disability and unemployment. Long-term behavioral impairments which
      affected the individual's occupation, lifestyle, and family frequently occurred in
      individuals with mild to moderate brain injuries who physically fully recovered. In-vitro and
      in-vivo studies showed a better recovery of cognitive function after administration of
      exogenous lactate in traumatic brain injury. Therefore, this study is aimed to evaluate the
      effect of exogenous lactate infusion contained in hyperosmolar sodium lactate solution on
      cognitive function assessed by Mini Mental State Examination(MMSE)scale.
    

Detailed description: 
      Mild traumatic brain injury (TBI) is the most common type of brain injury. Post-mild TBI
      disability could stem from cognitive, physical, psychological and social dysfunction which
      resulted in significant disability and unemployment. Cognitive impairment post traumatic
      brain injury is due to the disruption of brain vascular bed and microstructural damage.
      Currently, there is no specific therapy for individual with mild TBI. Neuropsychological
      assessment and early management immediately after mild traumatic brain injury have been shown
      to reduce long term cognitive disability. In-vitro and in-vivo studies showed a better
      recovery of cognitive function after administration of exogenous lactate in traumatic brain
      injury.

      The role of lactate in cerebral energy metabolism has been investigated widely. The ability
      of lactate as the sole energy substrate to support synaptic function has been demonstrated by
      different studies. In many studies, lactate has been proven to be a preferred or even an
      obligatory substrate over glucose for aerobic energy production during the initial stage of
      recovery from cerebral ischemia or hypoxia for recovery from ATP-depleted synaptic function
      and exogenously supplied lactate can support the early recovery of synaptic function after
      hypoxia.

      However, the clinical studies evaluated the effect of lactate administration on cognitive
      function in patients with mild traumatic brain injury are still limited. Therefore, we
      conduct a study to evaluate the effect of exogenous lactate infusion contained in
      hyperosmolar sodium lactate solution on cognitive function assessed by Mini Mental State
      Examination (MMSE) score evolution in mild traumatic brain injury compared with patients
      receiving hyperosmolar sodium chloride 3 % as a control group. MMSE score can be used as a
      tool to describe cognitive function.
    

Intervention name(s): hyperosmolar sodium lactate
Intervention type(s): Drug
Intervention description(s): Patients in this group received intravenous infusion of hyperosmolar sodium lactate at 1.5 ml.KgBW-1 within 15 minutes before neurosurgery
Other intervention name(s): Totilac
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: brain injury; cognitive function; sodium lactate; MMSE score