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Practical Aspects of Cerebral Microdialysis

Practical Aspects of Cerebral Microdialysis. Sandy Cecil RN, CCRN, CNRN Legacy Emanuel Medical Center Portland, Oregon. Objectives. Cerebral microdialysis: the basics How we ’ ve implemented a microdialysis program at LEMC Other forms of neuromonitoring at LEMC

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Practical Aspects of Cerebral Microdialysis

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  1. Practical Aspects of Cerebral Microdialysis Sandy Cecil RN, CCRN, CNRN Legacy Emanuel Medical Center Portland, Oregon

  2. Objectives Cerebral microdialysis: the basics How we’ve implemented a microdialysis program at LEMC Other forms of neuromonitoring at LEMC How this wealth of information has helped us in the clinical setting

  3. What is Cerebral Microdialysis? Cerebral microdialysis is a technique to sample the chemistry of the brain tissue Minimally invasive Easy to use at the bedside

  4. Microdialysis: Background Cerebral microdialysis has been used in research applications for over 20 years Clinical use after 2005 with FDA approval

  5. NAD ADP ATP NADH Glucose During Glycolysis Glucose is metabolized to Pyruvate In ischemic conditions Pyruvate cannot be metabolized in the Citric Acid Cycle and is metabolized to Lactate Pyruvate Oxygen Citric Acid ATP Cycle

  6. ADP ATP + NAD This is shown as an increase in the L/P ratio and a decrease in glucose Glucose + NAD NADH L/P Ratio Glucose Lactate Pyruvate Ischemia Citric Acid Cycle ATP ATP ATP

  7. Principles of Microdialysis Cell Blood capillary Microdialysis catheter Extracellular fluid

  8. Conclusion • Can predict outcome in TBI and SAH • Finding its way into routine multimodal monitoring in the neuro ICU setting • Well established technology for chemical monitoring of the brain tissue • Clinician can individualize treatment http://www.microdialysis.se/

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