Cerebral Microdialysis: Research Technique or Clinical Tool

Cerebral microdialysis is a well-established laboratory tool that is now widely used as a bedside monitor of brain tissue biochemistry during neurointensive care. With its ability to create a facsimile of brain tissue extracellular fluid (ECF) and characterize metabolic and biochemical changes, cerebral microdialysis is able to elucidate pathophysiological processes after brain injury and provide objective endpoints for clinical interventions and research. Microdialysis allows early recognition of cerebral hypoxia/ischemia and bioenergetic failure by monitoring changes in brain ECF glucose, lactate, pyruvate, glycerol, and glutamate concentrations. However, the sensitivity and specificity of microdialysis markers of ischemia and bioenergetic failure are not well characterized and there are no data to confirm whether microdialysis-guided therapy can influence outcome. The development of a system providing rapid analysis in “real time” is crucial to maximize the clinical applicability of the microdialysis technique.