Hyperlactatemia and other perioperative metabolic disturbances in neuroanesthesia 2023

Authors: Klimek, Markus et al 

Current Opinion in Anaesthesiology 35(5):p 537-542, October 2022.

Purpose of review

The concept of ‘brain-body cross-talking’ has gained growing interest in the last years. The understanding of the metabolic disturbances (e.g., hypernatraemia/hyponatraemia and hyperlactatemia) in neurosurgical patients has improved during the last years.

Recent findings

The impact of elevated lactate without acidosis in neurosurgical patients remains controversial. The pathophysiology of inappropriate secretion of antidiuretic hormone (SIADH) has become clearer, whereas the diagnosis of cerebral salt wasting should be used more carefully.

Summary

These findings will contribute to a better understanding of the pathophysiology involved and enable better prevention and therapy where possible in clinical practice.

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