Cerebral microdialysis (CMD) involves placement of a small catheter into the brain parenchyma, either during surgery or through a burr hole, secured by a cranial bolt. Extracellular concentrations of ischemic metabolites, such as lactate and pyruvate, can then be measured. The lactate: pyruvate ratio is currently the best marker of the brain redox state and an early biomarker of secondary ischemic injury. Glycerol, a marker of cell membrane damage, and glutamate, an excitatory amino acid, provide additional evidence of developing brain injury. CMD has been used, in the NICU arsenal of multimodal monitoring, to monitor patients with TBI and sub-arachnoid hemorrhage (SAH).
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Last date updated on June, 2014