title: Advanced monitoring in traumatic brain injury: microdialysis.
abstract: OBJECTIVE
  Here, we review the present state-of-the-art of microdialysis for monitoring patients with severe traumatic brain injury, highlighting the newest developments. Microdialysis has evolved in neurocritical care to become an established bedside monitoring modality that can reveal unique information on brain chemistry.
  
  
  RESULTS
  A major advance is recent consensus guidelines for microdialysis use and interpretation. Other advances include insight obtained from microdialysis into the complex, interlinked traumatic brain injury disorders of electrophysiological changes, white matter injury, inflammation and metabolism.
  
  
  CONCLUSIONS
  Microdialysis has matured into being a standard clinical monitoring modality that takes its place alongside intracranial pressure and brain tissue oxygen tension measurement in specialist neurocritical care centres, as well as being a research tool able to shed light on brain metabolism, inflammation, therapeutic approaches, blood-brain barrier transit and drug effects on downstream targets. Recent consensus on microdialysis monitoring is paving the way for improved neurocritical care protocols. Furthermore, there is scope for future improvements both in terms of the catheters and microdialysate analyser technology, which may further enhance its applicability.
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
authors.forename: Keri L H
authors.initials: KL
authors.lastname: Carpenter
authors.forename: Adam M H
authors.initials: AM
authors.lastname: Young
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hutchinson
mesh_terms: D001812:Blood-Brain Barrier; D000070642:Brain Injuries, Traumatic / Q000378:metabolism* / Q000628:therapy; D002560:Cerebrovascular Circulation / Q000502:physiology; D003422:Critical Care / Q000379:methods*; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D017551:Microdialysis; D008991:Monitoring, Physiologic / Q000379:methods*