Advertisement

Monitoring Microdialysis

  • Peter Reinstrup
  • Carl-Henrik Nordström
Chapter

Abstract

Microdialysis is an invasive technique based on placement of a small catheter into the brain parenchyma. The distal end of the catheter is a dialysis membrane. The lumen is perfused with Ringer acetate into which molecules are taken up by osmosis from the surrounding tissue. The irrigation fluid can be analysed online bedside (most commonly) or later at some convenient time. With the current technique, approximately 70% of the original parenchymal concentrations of the most commonly analysed substrates can be recovered in this fluid. By positioning the catheter in an area of interest, e.g. a contused area, the method can give consecutive samples of the extracellular fluid, thereby monitoring the ongoing metabolism of this tissue. The normally analysed substrates bedside is glucose, lactate, pyruvate, glycerol, and glutamate. It is recommended to use intracerebral microdialysis as a complement to intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring in severe cases of TBI subarachnoid haemorrhage and TBI. The lactate/pyruvate ratio is considered to be a sensitive marker for the development of ischemia, whereas glycerol is considered to reflect cell death.

Keywords

Cerebral Perfusion Pressure Dialysis Membrane Perfusion Fluid Irrigation Fluid Microdialysis Catheter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Hillered L, Persson L, Nilsson P, Ronne-Engstrom E, Enblad P (2006) Continuous monitoring of cerebral metabolism in traumatic brain injury: a focus on cerebral microdialysis. Curr Opin Crit Care 12(2):112–118PubMedCrossRefGoogle Scholar
  2. Nordström CH (2010) Cerebral energy metabolism and microdialysis in neurocritical care. Childs Nerv Syst 26(4):465–472PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Intensive and Perioperative CareSkanes University HospitalLundSweden
  2. 2.Department of NeurosurgeryOdense University HospitalOdenseDenmark

Personalised recommendations