Summary
Objective. To compare the properties of a new intracerebral micro-dialysis catheter with a high cut-off membrane (molecular cut-off 100 kDalton) with a standard catheter (CMA70, molecular cut-off 20 kDalton).
Methods. Paired intracerebral microdialysis catheters were inserted in fifteen comatose patients treated in a neurosurgical intensive care unit following subarachnoid haemorrhage or traumatic brain injury. The high-cut-off catheter (D100) differed from the CMA 70 catheter by the length (20 mm) and cut-off properties of the catheter membranes (100 kDalton) and the perfusion fluids used (Ringer-Dextran 60). Samples were collected every 4–6 hours, analyzed bedside (for glucose, glutamate, glycerol, lactate, pyruvate and urea) and later in the laboratory (for total protein).
Results. Fluid recovery was similar for the two types of catheters, but significantly more protein was recovered by the D100 catheter. The recovery of glycerol and pyruvate did not differ, while minor differences in recovery of glutamate and glucose were observed. The recovery of lactate was considerably lower in the D100 catheter (p < 0.01), influencing the lactate/pyruvate-ratio. The patterns of concentration changes over time were consistent for all metabolites, and independent of type of catheter.
Conclusion. Microdialysis catheters with high cut-off membranes can be used in routine clinical practice in the NSICU, adding the possibility of macro-molecule sampling from the extracellular space during monitoring.
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References
HHP Beneviste (1990) ArticleTitleMicrodialysis: theory and application. Progr Neurobiol 35 195–215
CLM Hamani M Dujovny (1997) ArticleTitleMicrodialysis in the human brain: Review of its applications. Neurol Research 19 281–288 Occurrence Handle1:CAS:528:DyaK2sXktV2it7s%3D
LPL Hillered (1999) ArticleTitleNeurometabolic monitoring of the acutely injured human brain. Scand J Clin Invest [suppl] 229 9–18 Occurrence Handle1:STN:280:DyaK1M7pslemug%3D%3D
LPL Hillered (2003) ArticleTitleMicrodialysis for neurochemical monitoring of the human brain. Scand Cardiovasc J 37 7–13 Occurrence Handle10.1080/14017430310006974
J Hillman O Åneman C Anderson F Sjögren C Säberg P Mellergard (2005) ArticleTitleA microdialysis technique for routine measurement of macromolecules in the injured human brain. Neurosurgery 56 1264–1268 Occurrence Handle10.1227/01.NEU.0000159711.93592.8D Occurrence Handle15918942
PJOCM Hutchinson PG Al-Rawi LB Maskell R Kett-White AK Gupta HK Richards DB Hutchinsson PJ Kirkpatrick JD Pickard (2000) ArticleTitleClinical cerebral microdialysis: a methodological study. J Neurosurg 93 37–43 Occurrence Handle1:STN:280:DC%2BD3czjvV2lsA%3D%3D Occurrence Handle10883903
PJ Hutchinson MT O’Connel J Nortje P Smith PG Al-Rawi AK Gupta DK Menon JD Pickard (2005) ArticleTitleCerebral microdialysis methodology-evaluation of 20 kDa and 100 kDa catheters. Physiol Meas 26 423–428 Occurrence Handle10.1088/0967-3334/26/4/008 Occurrence Handle1:STN:280:DC%2BD2MvlsVantw%3D%3D Occurrence Handle15886437
J Kehr (1993) ArticleTitleA survey on quantitative microdialysis: theoretical models and practical implications. J Neurosci Meth 48 251–261 Occurrence Handle1:CAS:528:DyaK3sXlvFyktLw%3D
MCRM Morganti-Kossman PF Stahel T Kossman (2002) ArticleTitleInflammatory response in acute traumatic brain injury: a double-edged sword. Curr Opin Crit Care 8 101–105
AS Sarrafzadeh OW Sakowitz KL Kiening G Benndorf WR Lanksch AW Unterberg (2002) ArticleTitleBedside microdialysis: a tool to monitor cerebral metabolism in subarachnoid hemorrhage patients? Crit Care Med 30 1062–1070 Occurrence Handle12006804
NMP Ståhl Å Hallström U Ungerstedt CH Nordström (2000) ArticleTitleIntracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia and neurosurgery. Neurosurgery 47 701–710 Occurrence Handle10981758
NUU Ståhl CH Nordström (2001) ArticleTitleBrain energy metabolism during controlled reduction of cerebral perfusion pressure in severe head injuries. Intensive Care Med 27 1215–1223 Occurrence Handle11534571
U Ungerstedt (1991) ArticleTitlePrinciples and application for studies in animal and man. J Int Med 230 365–373 Occurrence Handle1:STN:280:By2D3Mzns10%3D
AWSO Unterberg AS Sarrafzadeh G Benndorf R Lannksch (2001) ArticleTitleRole of bedside microdialysis in the diagnosis of cerebral vasospasm following aneurismal subarachnoid hemorrhage. J Neurosurg 94 740–749 Occurrence Handle1:STN:280:DC%2BD3M3lsF2hsA%3D%3D Occurrence Handle11354405
DCCS Wilcockson DC Anthony VH Perry (2002) ArticleTitleThe systematic and local acute phase response following acute brain injury. J Cereb Blood Flow Metab 22 318–326 Occurrence Handle1:CAS:528:DC%2BD38XivFejtr8%3D Occurrence Handle11891437
CDIF Winter AK Pringle C Trikkas GF Clough MK Church (2002) ArticleTitleA microdialysis method for the recovery of IL-1b, IL-6 and nerve growth factor from human brain in vivo. J Neurosci Meth 119 45–50 Occurrence Handle1:CAS:528:DC%2BD38XntVeiurc%3D
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Hillman, J., Milos, P., Yu, Z. et al. Intracerebral microdialysis in neurosurgical intensive care patients utilising catheters with different molecular cut-off (20 and 100 kD). Acta Neurochir (Wien) 148, 319–324 (2006). https://doi.org/10.1007/s00701-005-0670-8
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DOI: https://doi.org/10.1007/s00701-005-0670-8