Neurocritical Care

, Volume 29, Issue 3, pp 496–503 | Cite as

Cerebral Metabolic Changes Related to Oxidative Metabolism in a Model of Bacterial Meningitis Induced by Lipopolysaccharide

  • M. Munk
  • F. R. Poulsen
  • L. Larsen
  • C. H. Nordström
  • T. H. NielsenEmail author
Translational research



Cerebral mitochondrial dysfunction is prominent in the pathophysiology of severe bacterial meningitis. In the present study, we hypothesize that the metabolic changes seen after intracisternal lipopolysaccharide (LPS) injection in a piglet model of meningitis is compatible with mitochondrial dysfunction and resembles the metabolic patterns seen in patients with bacterial meningitis.


Eight pigs received LPS injection in cisterna magna, and four pigs received NaCl in cisterna magna as a control. Biochemical variables related to energy metabolism were monitored by intracerebral microdialysis technique and included interstitial glucose, lactate, pyruvate, glutamate, and glycerol. The intracranial pressure (ICP) and brain tissue oxygen tension (PbtO2) were also monitored along with physiological variables including mean arterial pressure, blood glucose, lactate, and partial pressure of O2 and CO2. Pigs were monitored for 60 min at baseline and 240 min after LPS/NaCl injection.


After LPS injection, a significant increase in cerebral lactate/pyruvate ratio (LPR) compared to control group was registered (p = 0.01). This increase was due to a significant increased lactate with stable and normal values of pyruvate. No significant change in PbtO2 or ICP was registered. No changes in physiological variables were observed.


The metabolic changes after intracisternal LPS injection is compatible with disturbance in the oxidative metabolism and partly due to mitochondrial dysfunction with increasing cerebral LPR due to increased lactate and normal pyruvate, PbtO2, and ICP. The metabolic pattern resembles the one observed in patients with bacterial meningitis. Metabolic monitoring in these patients is feasible to monitor for cerebral metabolic derangements otherwise missed by conventional intensive care monitoring.


Meningitis Lipopolysaccharide Microdialysis Mitochondrial dysfunction 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

12028_2018_509_MOESM1_ESM.jpg (226 kb)
Supplementary Fig. 1 Glutamate and glycerol at baseline (0-60 min) and after LPS or NaCl injection in the LPS and Control group respectively. For glutamate, no difference from baseline was found in either group. Glycerol tended to increase in the LPS group after LPS injection. The increase was not significant (JPEG 226 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Southern Denmark School of MedicineOdenseDenmark
  2. 2.Department of NeurosurgeryOdense University HospitalOdenseDenmark
  3. 3.Department of Infectious DiseasesOdense University HospitalOdenseDenmark
  4. 4.Department of NeurosurgeryStanford University School of MedicineStanfordUSA

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