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Microdialysis is a minimally invasive method which enables continuous monitoring of parameters in the extracellular space of various tissues. It has been investigated in animal models for over a decade, and many publications have provided insight into its advantages and disadvantages. However, in spite of its enormous potential for revealing metabolic processes in normal and pathological tissue, microdialysis in humans is still in its infancy. Clinical neurointensive medicine nowadays demands much more than conventional monitoring methods. As already shown by jugular bulb measurements of oxygen and lactate, in the future clinicians will want to have access to continuous neurochemical information from the patient. This information could be used to prevent those enigmatic secondary lesions which play such a negative role in neurointensive medicine, or at least enable treatment of them at an early stage. The extensive information now available from the laboratory would help with the interpretation of clinical analogues. In the University Clinic of Neurosurgery in Basel we have been involved in the field of micro dialytic monitoring for several years and have recognised the problems, both technical and ethical, which are involved in taking the difficult step from animal experiments to clinical application. In 1994 we thought that research on clinical microdialysis had reached the stage which would enable scientists and clinicians to have many fruitful discussions.
List of contents
Basic Science and Methodology.- Possible Glial Contribution of Rat Hippocampus Lactate as Assessed with Microdialysis and Stress.- Application of Glutamate in the Cortex of Rats: A Microdialysis Study.- Clinical Microdialysis: The Role of On-line Measurement and Quantitative Microdialysis.- Intracerebral Microdialysis Markedly Inhibits the Propagation of Cortical Spreading Depression.- Delayed Neuronal Damage Following Focal Ischemic Injury in Stroke-Prone Spontaneously Hypertensive Rats.- The Measurement of Extracellular Inorganic Phosphate Gives a More Reliable Indication for Severe Impairment of Cerebral Cell Function and Cell Death than the Measurement of Extracellular Lactate.- Clinical Investigations.- A Concept for the Introduction of Cerebral Microdialysis in Neurointensive Care.- Lactic Acid and Amino Acid Fluctuations Measured Using Microdialysis Reflect Physiological Derangements in Head Injury.- Glutamate Release and Cerebral Blood Flow After Severe Human Head Injury.- Increased Levels of Glutamate in Patients with Subarachnoid Haemorrhage as Measured by Intracerebral Microdialysis.- Microdialytic Monitoring of the Cortex During Neurovascular Surgery.- In vivo Microdialysis Study of Extracellular Glutamate Response to Temperature Variance in Subarachnoid Hemorrhage.- Antiepileptic Drug Pharmacokinetics in Patients with Epilepsy Using a New Microdialysis Probe: Preliminary Observations.- A New Screwing Device for Fixing a Microdialysis Probe in Critical Care Patients.- A Novel Microdialysis Probe Designed for Clinical Use: Potential Analytical and Therapeutic Applications.- Microdialytic Monitoring During a Cardiovascular Operation.- Index of Keywords.
