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

Monitoring and detection of vasospasm II: EEG and invasive monitoring.
Hänggi D; Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage. Hänggi D, et al. Neurocrit Care. 2011 Sep;15(2):318-23. doi: 10.1007/s12028-011-9583-y. Neurocrit Care. 2011. PMID: 21748504 Review.
Intracerebral temperature monitoring in severely head injured patients.
Verlooy J, Heytens L, Veeckmans G, Selosse P. Verlooy J, et al. Acta Neurochir (Wien). 1995;134(1-2):76-8. doi: 10.1007/BF01428508. Acta Neurochir (Wien). 1995. PMID: 7668133
Chemical monitoring of intensive care patients using intravenous microdialysis.
Stjernström H, Karlsson T, Ungerstedt U, Hillered L. Stjernström H, et al. Intensive Care Med. 1993;19(7):423-8. doi: 10.1007/BF01724886. Intensive Care Med. 1993. PMID: 8270725
A review of flux considerations for in vivo neurochemical measurements.
Paul DW, Stenken JA. Paul DW, et al. Analyst. 2015 Jun 7;140(11):3709-30. doi: 10.1039/c4an01898b. Analyst. 2015. PMID: 25977941 Free PMC article. Review.
Review of microdialysis in brain tumors, from concept to application: first annual Carolyn Frye-Halloran symposium.
Benjamin RK, Hochberg FH, Fox E, Bungay PM, Elmquist WF, Stewart CF, Gallo JM, Collins JM, Pelletier RP, de Groot JF, Hickner RC, Cavus I, Grossman SA, Colvin OM. Benjamin RK, et al. Neuro Oncol. 2004 Jan;6(1):65-74. doi: 10.1215/S1152851703000103. Neuro Oncol. 2004. PMID: 14769143 Free PMC article.

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