Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis - PubMed (original) (raw)

Case Reports

Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis

L Persson et al. J Neurosurg. 1992 Jan.

Abstract

The authors have used intracerebral microdialysis to develop a method for routine monitoring of disturbances in brain energy metabolism in patients in the neurosurgical intensive care unit. Microdialysis was conducted for periods ranging from 2.3 to 8.3 days in four patients (three with severe head injuries and one with severe subarachnoid hemorrhage). Altogether, 4447 chemical analyses from 587 dialysis samples were carried out. Concentrations of the energy-related metabolites lactate, pyruvate, and hypoxanthine were measured, and the lactate:pyruvate ratio was calculated. In addition, the acids glutamate, aspartate, taurine, glutamine, asparagine, and glycine were measured in one patient. The microdialysis data were matched with various clinical events, including intracranial hypertension and therapeutic interventions such as initiation or withdrawal of barbiturates and cerebrospinal fluid drainage. The present study shows that microdialysis can be used for long-term measurement of extracellular fluid (ECF) energy-related metabolites and amino acids in the frontal cortex of neurosurgical patients in a clinical setting. Fluctuations of the measured ECF energy-related substances corresponded to various clinical events presumably involving hypoxia/ischemia. The authors found a 25-fold increase in ECF glutamate, aspartate, and taurine under conditions of energy perturbation, as indicated by high levels of the lactate:pyruvate ratio, lactate, and hypoxanthine. The use of long-term intracerebral microdialysis in patients opens a new field of clinical research, with many possibilities for improving insight into intracranial dynamics in acute cerebral conditions.

PubMed Disclaimer

Cited by

Baseline levels of glucose metabolites, glutamate and glycerol in malignant glioma assessed by stereotactic microdialysis.
Roslin M, Henriksson R, Bergström P, Ungerstedt U, Bergenheim AT. Roslin M, et al. J Neurooncol. 2003 Jan;61(2):151-60. doi: 10.1023/a:1022106910017. J Neurooncol. 2003. PMID: 12622454
Protective effect of transgenic expression of porcine heat shock protein 70 on hypothalamic ischemic and oxidative damage in a mouse model of heatstroke.
Chen ZC, Wu WS, Lin MT, Hsu CC. Chen ZC, et al. BMC Neurosci. 2009 Sep 3;10:111. doi: 10.1186/1471-2202-10-111. BMC Neurosci. 2009. PMID: 19725984 Free PMC article.
Effects of hypertonic (3%) saline in rats with circulatory shock and cerebral ischemia after heatstroke.
Kuo JR, Lin CL, Chio CC, Wang JJ, Lin MT. Kuo JR, et al. Intensive Care Med. 2003 Sep;29(9):1567-73. doi: 10.1007/s00134-003-1854-4. Epub 2003 Jun 19. Intensive Care Med. 2003. PMID: 12819882
(13)C-labelled microdialysis studies of cerebral metabolism in TBI patients.
Carpenter KL, Jalloh I, Gallagher CN, Grice P, Howe DJ, Mason A, Timofeev I, Helmy A, Murphy MP, Menon DK, Kirkpatrick PJ, Carpenter TA, Sutherland GR, Pickard JD, Hutchinson PJ. Carpenter KL, et al. Eur J Pharm Sci. 2014 Jun 16;57(100):87-97. doi: 10.1016/j.ejps.2013.12.012. Epub 2013 Dec 20. Eur J Pharm Sci. 2014. PMID: 24361470 Free PMC article. Review.
Microdialysis in central nervous system disorders and their treatment.
McAdoo DJ, Wu P. McAdoo DJ, et al. Pharmacol Biochem Behav. 2008 Aug;90(2):282-96. doi: 10.1016/j.pbb.2008.03.001. Epub 2008 Mar 10. Pharmacol Biochem Behav. 2008. PMID: 18436292 Free PMC article. Review.

Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis - PubMed (original) (raw)