Cerebral microdialysis: research technique or clinical tool

Abstract

Cerebral microdialysis is a well-established laboratory tool that is increasingly used as a bedside monitor to provide on-line analysis of brain tissue biochemistry during neurointensive care. This review describes the principles of cerebral microdialysis and the rationale for its use in the clinical setting, including discussion of the most commonly used microdialysis biomarkers of acute brain injury. Potential clinical applications are reviewed and future research applications identified. Microdialysis has the potential to become an established part of mainstream multi-modality monitoring during the management of acute brain injury but at present should be considered a research tool for use in specialist centres.

Studying the central control of food intake and obesity in rats

“…After equilibration between the two compartments, the composition of the collected microdialysate reflects that of the brain extracellular fluid. The microdialysis perfusion thus provides a way to monitor in vivo neurochemistry of specific brain regions and it has been widely used to estimate neurotransmitter release [23][24][25][26][27] . A less explored but also useful feature of the technique is that it allows the supplying of a substance or drug to the tissue, by adding it to the perfusing solution, a feature known as reverse dialysis or retrodialysis.…”

“…Brain MD is also applicable to humans. Monitoring of brain metabolism, through determination of glucose, lactate, and pyruvate levels during brain surgeries, has been one of its applications [23][24][25][26][27] . These latter aspects will not be considered in the following text.…”

“…and membrane lengths between of 1.0 to 4.0mm, depending on the brain area. Typically, each dialysate sample is collected for 10 to 20min [23][24][25][26][27] .…”

A model for simulation and patient-specific visualization of the tissue volume of influence during brain microdialysis

“…The method uses a catheter, mimicking a blood capillary, which can be inserted into a variety of tissues. Cerebral microdialysis is used for bedside monitoring in neuro-intensive care [2] as well as a research tool within areas such as drug delivery and neuro-oncology [3].…”

Is cerebral microdialysis a clinical tool?

“…Glucose is a direct measure of substrate delivery to the brain tissue, and glycerol is a marker of cell membrane breakdown. As well as its use in intraoperative monitoring, cerebral microdialysis is also commonly used in the intensive care setting, usually with hourly sampling, as part of multimodality monitoring of intubated and ventilated neurosurgical patients: typically in subarachnoid haemorrhage or traumatic brain injury [4]. Relationships between brain chemistry and clinical outcome have been established [3].…”