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7 - Brain tissue biochemistry

from Section 2 - Monitoring and imaging

Published online by Cambridge University Press:  05 December 2011

By
Arnab Ghosh  and
Martin Smith
Edited by
Basil F. Matta ,
David K. Menon  and
Martin Smith
Basil F. Matta
Affiliation:
Addenbrooke's Hospital, Cambridge
David K. Menon
Affiliation:
Addenbrooke's Hospital, Cambridge
Martin Smith
Affiliation:
Department of Neuroanaesthesia and Neurocritical Care, the National Hospital for Neurology and Neurosurgery, University College London Hospitals
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Summary

Cerebral microdialysis is now widely used as a bedside monitor of brain tissue biochemistry to identify cerebral hypoxia/ischaemia and assess cellular bioenergetics after brain injury. This chapter reviews the principles of cerebral microdialysis and identifies its role in detecting derangements of cerebral metabolism after brain injury. Microdialysis is used for a variety of clinical indications, including tissue monitoring in myocutaneous flap surgery, transplant surgery and bowel anastamoses. The concentration of substances in the dialysate will depend on the balance between substrate delivery to, and uptake from, the brain extracellular fluid (ECF) but also on several other factors. The pathophysiology of acute brain injury is complex, but two factors are of crucial importance: reduction of substrate delivery below critical thresholds, and the inability of brain cells to utilize delivered oxygen and glucose because of failing cellular metabolism.
Type
Chapter
Information
Core Topics in Neuroanaesthesia and Neurointensive Care , pp. 85 - 100
Publisher: Cambridge University Press
Print publication year: 2011

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