Cerebral Microdialysis Monitoring to Improve Individualized Neurointensive Care Therapy: An Update of Recent Clinical Data.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_784284DDAF70
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Cerebral Microdialysis Monitoring to Improve Individualized Neurointensive Care Therapy: An Update of Recent Clinical Data.
Journal
Frontiers in neurology
Author(s)
Carteron L., Bouzat P., Oddo M.
ISSN
1664-2295 (Print)
ISSN-L
1664-2295
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
8
Pages
601
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
Cerebral microdialysis (CMD) allows bedside semicontinuous monitoring of patient brain extracellular fluid. Clinical indications of CMD monitoring are focused on the management of secondary cerebral and systemic insults in acute brain injury (ABI) patients [mainly, traumatic brain injury (TBI), subarachnoid hemorrhage, and intracerebral hemorrhage (ICH)], specifically to tailor several routine interventions-such as optimization of cerebral perfusion pressure, blood transfusion, glycemic control and oxygen therapy-in the individual patient. Using CMD as clinical research tool has greatly contributed to identify and better understand important post-injury mechanisms-such as energy dysfunction, posttraumatic glycolysis, post-aneurysmal early brain injury, cortical spreading depressions, and subclinical seizures. Main CMD metabolites (namely, lactate/pyruvate ratio, and glucose) can be used to monitor the brain response to specific interventions, to assess the extent of injury, and to inform about prognosis. Recent consensus statements have provided guidelines and recommendations for CMD monitoring in neurocritical care. Here, we summarize recent clinical investigation conducted in ABI patients, specifically focusing on the role of CMD to guide individualized intensive care therapy and to improve our understanding of the complex disease mechanisms occurring in the immediate phase following ABI. Promising brain biomarkers will also be described.

Keywords
Neurology, Clinical Neurology, biomarkers, cerebral metabolism, hypoxia, ischemia, microdialysis, neurointensive care, subarachnoid hemorrhage, traumatic brain injury
Pubmed
Web of science
Open Access
Yes
Create date
27/11/2017 17:21
Last modification date
20/08/2019 14:35
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