EFFECT OF 5-AMINOLAEVULENIC ACID ON POSTOPERATIVE LACTATE LEVELS IN PATIENTS UNDERGOING SURGERY FOR MALIGNANT BRAIN TUMOURS

G Baake,Mw Nijsten,W Bult,Fe Van Gelder

doi:10.1186/2197-425x-3-s1-a976

G Baake, Mw Nijsten + Show 2 more

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https://doi.org/10.1186/2197-425x-3-s1-a976

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Abstract

5-aminolaevulinic acid (5-ALA) is a natural precursor of haemoglobin. Exogenously administered 5-ALA can lead to intracellular accumulation of fluorescent porphyrins in malignant tissues, such as glioblastoma. 5-ALA is increasingly used to improve tumour visualisation and enable more optimal resection of malignant gliomas. In vitro, 5-ALA can cause oxidative damage to rat liver mitochondria. In vivo, rats exposed to 5-ALA developed increased lactate levels; possibly because inhibition of oxidative metabolism [1]. Univariate data also suggested an effect of 5-ALA in neurosurgical patients [2]. Since lactate levels are widely used to monitor patients, we performed multivariate analysis on the impact of 5-ALA on lactate levels.

Highlights

Asses the relation of preoperative 5-aminolaevulinic acid (5-ALA) on postoperative systemic lactate levels in patients undergoing surgery for malignant brain tumours
The decision to use 5-ALA was at the discretion of the neurosurgeon and was based on the specific tumour characteristics on preoperative imaging
From 2007 to 2014 we included 350 patients aged 56 ± 14, 60% males. 89 patiens (25%) received 5-ALA. These patients were older than controls (62 ± 8 vs. 53 ± 15;p < 0.001); duration of operation did not differ between the control and 5-ALA groups (NS)

Summary

Introduction

Objectives Asses the relation of preoperative 5-ALA on postoperative systemic lactate levels in patients undergoing surgery for malignant brain tumours. Methods In an observational study in a cohort of neurosurgical patients who underwent resection of a suspected malignant glioma and were postoperatively admitted to our ICU, we compared lactate levels between patients who received 5-ALA preoperatively (5-ALA group) and those who did not (control group). The decision to use 5-ALA was at the discretion of the neurosurgeon and was based on the specific tumour characteristics on preoperative imaging.

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