Cerebral microdialysis in traumatic brain injury and subarachnoid hemorrhage: state of the art.
Cerebral microdialysis (CMD) is a laboratory tool that provides on-line analysis of brain biochemistry via a thin, fenestrated, double-lumen dialysis catheter that is inserted into the interstitium of the brain. A solute is slowly infused into the catheter at a constant velocity. The fenestrated membranes at the tip of the catheter permit free diffusion of molecules between the brain interstitium and the perfusate, which is subsequently collected for laboratory analysis. The major molecules studied using this method are glucose, lactate, pyruvate, glutamate, and glycerol. The collected substances provide insight into the neurochemical features of secondary injury following traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) and valuable information about changes in brain metabolism within a short time frame. In this review, the authors detail the CMD technique and its associated markers and then describe pertinent findings from the literature about the clinical application of CMD in TBI and SAH.
Division of Neurological Surgery, Hospital das Clinicas, School of Medicine, University of São Paulo, Rua Loefgreen, 1.272 - Vila Clementino, São Paulo, SP, 04040-001, Brazil.
Marcelo
M
de Lima Oliveira
Ana Carolina
AC
Kairalla
Erich Talamoni
ET
Fonoff
Raquel Chacon Ruiz
RC
Martinez
Manoel Jacobsen
MJ
Teixeira
Edson
E
Bor-Seng-Shu
D001930:Brain Injuries / Q000378:metabolism*; D006801:Humans; D017551:Microdialysis / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D013345:Subarachnoid Hemorrhage / Q000378:metabolism*