Effect of Exogenous Lactate on Neurocognitive in Brain Trauma
Effect of Exogenous Lactate on Neurocognitive in Brain Trauma
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.
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.
Inclusion Criteria:

 -  Mild traumatic brain injury

 -  Glasgow Coma Scale (GCS) of 14-15

 -  Requires emergency neurosurgery procedures

 -  Physical status ASA I-II

 -  Onset of trauma < 9 hours

 Exclusion Criteria:

 -  Multiple injury

 -  Pregnancy/lactation

 -  History of alcohol or barbiturate consumption prior to the injury