Evaluation of sex differences in acid/base and electrolyte concentrations in acute large vessel stroke

Sarah R. Martha, Lisa A. Collier, Stephanie M. Davis, Akin Erol, Doug Lukins, Keith R. Pennypacker, Justin F. Fraser

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations


Introduction: Ischemic stroke is the one of the most severe and debilitating diseases, and despite animal models, there is much to learn about the neuropathology in humans in a way that could inform the development of therapies. We have developed a protocol to collect and evaluate arterial blood immediately distal and proximal from the removed intracranial thrombus during mechanical thrombectomy. These samples provide a unique resource in evaluating acute changes in acid/base and electrolyte concentrations at the time of ischemic stroke. The purpose of this study was to compare acid/base and electrolytes obtained proximal and distal to the occluded intracranial thrombi between male and female acute ischemic stroke subjects at the time of thrombectomy; and to determine whether arterial blood gas values predict outcomes in male and female subjects. Methods: We analyzed the first 49 subjects (age = 67 ± 15.0, 21 males) in the BACTRAC registry. We compared arterial blood gas of blood distal versus proximal to the thrombus during thrombectomy which provided acid/base levels (pH, pCO2, pO2, BD, HCO3 ) and electrolyte values (iCa2+, K+, and Na+). Comparisons were evaluated by one-way repeated measures ANOVA (p <.05). Moderated multiple regression with an interaction term of sex determined predictors of infarct volume, edema volume, and infarct time. Results: In general, distal intracranial luminal blood sample showed a compensated metabolic acidosis with an elevated oxygen concentration in both blood samples. Analysis indicated several significant differences in the proximal blood samples between sexes (pH, pCO2, and K+). Bicarbonate and base deficit were predictors of infarct time specifically in female subjects. Discussion and conclusion: Acid/base and electrolyte response to ischemic conditions differ between men and women, and these early changes could be used to predict local acid/base changes and how they develop differently in men and women during ischemia. These findings provide a novel insight into the pathology of large vessel stroke in humans, particularly potential variations based on sex.

Original languageEnglish
Article number113078
JournalExperimental Neurology
StatePublished - Jan 2020

Bibliographical note

Publisher Copyright:
© 2019 Elsevier Inc.


  • Acid/base
  • Electrolytes
  • Ischemic stroke
  • Sex differences

ASJC Scopus subject areas

  • Neurology
  • Developmental Neuroscience


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