Neurochemical changes following combined hypoxemia and hemorrhagic shock in a rat model of penetrating ballistic-like brain injury: A microdialysis study.

Background: Energy metabolic dysfunction is a key determinant of cellular damage following traumatic brain injury and may be worsened by additional insults. This study evaluated the acute/subacute effects of combined hypoxemia (HX) and hemorrhagic shock (HS) on cerebral interstitial levels of glucose, lactate and pyruvate in a rat model of penetrating ballistic-like brain injury (PBBI). Methods: Rats were randomly assigned into the sham control, PBBI and combined injury (P+HH) groups. The P+HH group received 30-minute HX following PBBI followed by 30-minute HS. Samples were collected from striatum (peri-lesional region) using intracerebral microdialysis at 1-3 hours post-injury and then at 1-3, 7 and 14 days post-injury. Glucose, lactate and pyruvate were measured in the dialysate samples. Results: Glucose levels dropped significantly up to 24 hours following injury in both PBBI and P+HH groups (p

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