[Cerebral microdialysis as a clinical tool].
Microdialysis is the only technique available for cerebral metabolic monitoring in the clinical setting. By the mean of a probe inserted in the brain, it provides an extracellular space sampling. Values of various substrates including cerebral glucose, lactate, pyruvate, glycerol or glutamate can be obtained at the bedside at intervals between minutes and hours. Values are critically dependent on the flow of the perfusion liquid and reflect a highly localized cerebral metabolism. Cerebral microdialysis improves our understanding of acute neurological events such as intracranial hypertension or decrease in brain tissue oxygen pressure. Cerebral microdialysis can be used for detection of ischaemia, especially after malignant stroke or vasospasm complicating subarachnoid haemorrhage. In these cases, it may influence the therapeutic management. Moreover, it permits the assessment of metabolic changes after therapeutic interventions. Finally, some markers (like lactate/pyruvate ratio) are related to outcome, especially after traumatic brain injury.
Audibert
G
G
Département d'anesthésie-réanimation, hôpital central, CHU de Nancy, 54000 Nancy, France. g.audibert@chu-nancy.fr
Charpentier
C
C
Mertes
P-M
PM
D000818:Animals; D015415:Biomarkers; D001923:Brain Chemistry / Q000502:physiology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D002545:Brain Ischemia / Q000175:diagnosis / Q000503:physiopathology; D005110:Extracellular Space; D006801:Humans; D017551:Microdialysis
D015415:Biomarkers