Abstract
Brain microdialysis is a well-established technique used to monitor the chemistry of the extracellular space in the brain during neurointensive care. Microdialysis may be useful in severe cases of traumatic brain injury, stroke, and hypoxic brain injury in which monitoring of intracranial pressure and cerebral perfusion pressure is required. The parenchymal concentrations of glucose, lactate, pyruvate, glutamate, and glycerol can be measured at the bedside. As the primary source of energy, glucose is an important marker of changes in cerebral metabolism and reflects systemic supply, which is influenced by capillary perfusion, ischemia, and blood glucose concentration. The lactate–pyruvate (L/P) ratio is a sensitive marker of changes in the redox state of cells brought about by ischemia. The glutamate concentration is an indirect marker of cell damage or ischemia. Glycerol concentration reflects cell membrane damage, as glycerol is an integral component of cell membranes. Loss of energy due to ischemia eventually leads to an influx of calcium and a decomposition of cell membranes, which liberates glycerol into the interstitial fluid. Microdialysis, when used with other brain monitoring techniques, may be a useful means of preventing and relieving secondary ischemic injury, predicting outcome and guiding therapy after severe brain damage. However, the value of microdialysis as a tool in routine neurointensive care decision-making remains unclear.
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© 2015 Springer Japan
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Kuroda, Y., Kawai, N., Kawakita, K. (2015). Role of Microdialysis in Neuroanesthesia. In: Uchino, H., Ushijima, K., Ikeda, Y. (eds) Neuroanesthesia and Cerebrospinal Protection. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54490-6_17
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DOI: https://doi.org/10.1007/978-4-431-54490-6_17
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-54489-0
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