Experimental and clinical monitoring of glucose by microdialysis.
The aim of this investigation was to assess the use of cerebral extracellular glucose as a parameter for microdialytic monitoring in neurosurgical critical care patients. Samples were collected from four patients with severe head injury and one with subarachnoid haemorrhage for periods of 4.5-67 h. Glucose and lactate were analysed in the dialysates. The ratios of glucose to lactate were calculated to partially allow for changes in microdialytic conditions over time. On-line pH was measured for up to 3 days in three patients. In experiments with spontaneous hypertensive rats we found that extracellular glucose became unmeasurable in the ischemic zone after middle cerebral artery occlusion. Similarly, in 3 patients glucose became undetectable for several hours, and glucose/lactate tended to decrease during measurement. This was accompanied by high ICP in one patient, and by a hypoxic episode in another. In the two other patients glucose/lactate ratios showed a rising trend. Findings indicate that glucose, and the glucose/lactate ratio show some correlations with clinical course and are promising parameters for cerebral monitoring and therapeutic decision making.
Langemann
H
H
Department of Research, Cantonal Hospital, Basel, Switzerland.
Mendelowitsch
A
A
Landolt
H
H
Alessandri
B
B
Gratzl
O
O
D000328:Adult; D000368:Aged; D000818:Animals; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000503:physiopathology*; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006406:Hematoma / Q000503:physiopathology; D006801:Humans; D007773:Lactates / Q000378:metabolism; D008297:Male; D017551:Microdialysis; D008875:Middle Aged; D051381:Rats; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors
D007773:Lactates; D005947:Glucose