Neurochemical Monitoring in the Intensive Care Unit

1. Front Matter

   Pages III-XIX

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2. Basic Problems of Microdialysis Technique

   1. Front Matter

      Pages 1-1

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   2. Basic Problems in Clinical Application of Microdialysis Technique

      • Yoichi Katayama

      Pages 3-25

   3. Glutamate Neurotoxicity As a Mechanism of Ischemic Brain Damage: A Basic Study Using a New In Vivo Model

      • Hirosuke Fujisawa, Hans Landolt, Ross Bullock

      Pages 26-33

   4. Delayed Neuronal Damage Following Focal Ischemic Injury in Stroke-Prone Spontaneously Hypertensive Rats

      • Toshiki Shirotani, Katsuji Shima, Miwako Iwata, Hideyuki Kita, Hiroo Chigasaki

      Pages 34-41

   5. Prolonged Stimulation-Induced Afterdischarges of Hippocampal CA1 Pyramidal Cells After Ischemia In Vivo

      • Makoto Furuichi, Shuhei Miyazaki, Yoichi Katayama, Takashi Tsubokawa

      Pages 42-46

   6. The Use of Microdialysis for Monitoring the Effect of the Neuroprotective Drug CI-977 on Extracellular Excitatory Amino Acids

      • S. Galbraith, K. B. Mackay, T. R. Patel, J. McCulloch

      Pages 47-56

3. Clinical Application of Microdialysis Technique

   1. Front Matter

      Pages 57-57

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   2. Microdialysis for Neurochemical Monitoring in Human Brain Injuries

      • Lars Hillered, Lennart Persson

      Pages 59-63

   3. Patterns of Excitatory Amino Acid Release and Ionic Flux After Severe Human Head Trauma

      • R. Bullock, A. Zauner, O. Tsuji, J. J. Woodward, A. T. Marmarou, H. F. Young

      Pages 64-71

   4. Measurement of Excitatory Amino Acid Release in Glioma and Contused Brain Tissue During Intracranial Surgery

      • Tatsuro Kawamata, Yoichi Katayama, Kosaku Kinoshita, Takashi Tsubokawa

      Pages 72-77

   5. Measurement of Lactic Acid and Amino Acids in the Cerebral Cortex of Head-Injured Patients Using Microdialysis

      • J. Clay Goodman, Daniel P. Robertson, Shankar P. Gopinath, Raj K. Narayan, Robert G. Grossman, Richard K. Simpson Jr. et al.

      Pages 78-83

4. Clinical Impact of Jugular Bulb Oximetry

   1. Front Matter

      Pages 85-85

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   2. Benefits and Pitfalls of Jugular Bulb Venous Oxygen Saturation Monitoring

      • N. Mark Dearden

      Pages 87-97

   3. Continuous Monitoring of Jugular Venous Oxygen Saturation in Neurosurgical Intensive Care Units

      • Hiroyuki Yokota, Yasuhiro Yamamoto, Matoaki Nakabayashi, Akira Fuse, Kunihiro Mashiko, Hiroshi Henmi et al.

      Pages 98-104

   4. The Optimal Cerebral Perfusion Pressure for Management of Patients with Severe Brain Injury

      • K. H. Chan, S. C. P. Ng

      Pages 105-111

   5. Bilateral Jugular Bulb Oximetry

      • Hiroshi Inagawa, Yasusei Okada, Sou Suzuki, Kazuyuki Ono, Kazuhiko Maekawa

      Pages 112-119

   6. Causes and Treatment of Desaturation in SjO2 Monitoring

      • Motoaki Nakabayashi, Hiroyuki Yokota, Akira Fuse, Hidetaka Sato, Shigeki Kushimoto, Kazuyoshi Kato et al.

      Pages 120-126

   7. Evaluation of Continuous Monitoring of Jugular Venous Oxygen Saturation, Regional Cerebral Oxygen Saturation, and Electroencephalography Power Spectrum for Intraoperative Cerebral Ischemia

      • Yoshihiro Ikuta, Tatsuhiko Kano, Eiji Abe, Mari Seshita, Kanemitsu Higashi

      Pages 127-133

   8. Jugular Bulb Oxygen Saturation and Oxygen Consumption in Patients Receiving Barbiturate Therapy

      • Toshiaki Ikeda, Kazumi Ikeda, Narihiro Yoshimatsu, Hideto Kaneko, Masatoshi Sugi, Tohru Iizuka et al.

      Pages 134-139

Neurophysiological recording is the major neuromonitoring technique employed in ICU. In addition, continuous recording of intracranial pressure has proved to provide infomation useful for critical care of the patient with severe brain damage. It is, however, difficult to assess neurochemical and/or metabolic environments of the brain with these conventional neuromoni­ toring techniques. Information regarding these changes, if available on a real-time basis, is undoubtedly useful for patient care. Many important developments in bedside techniques to monitor these changes have been achieved during the last few years. It was the consensus of the editors that a symposium to exchange knowledge concerning recent advances in such techniques would be valuable. With this background, the First International Symposium of Neuro­ chemical Monitoring in ICU held May 20-21, 1994, in Tokyo, Japan. It was not the intention of the organizers that this symposium should survey the whole field of neuromonitoring in ICU. The symposium was thus focused on clinical application of microdialysis, jugular venous oximetry, and near­ infrared spectroscopy, which currently appear to be the most promising techniques for monitoring neurochemical and metabolic changes in the brain in a clinical setting. We termed these techniques collectively as neuro­ chemical monitoring, contrasting them with neurophysiological monitoring in ICU. The concept that has motivated this symposium was to provide an opportunity to exchange up-to-date summaries on issues currently debated for these techniques. This volume is based on the papers presented at the symposium.

• Brain trauma
• Critical care
• Juglar venous oximetry
• Microdialysis
• Near-infrared Spectroscopy
• clinical application

• Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan

  Takashi Tsubokawa

• Division of Neurosurgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA

  Anthony Marmarou

• Department of Neurosurgery, Baylor College of Medicine, Houston, USA

  Claudia Robertson

• Department of Neurosurgery, Southern General Hospital, University of Glasgow, Glasgow, Scotland, UK

  Graham Teasdale

Policies and ethics