OBJECTIVE: To introduce rapid-sampling microdialysis for the early detection of adverse metabolic changes in tissue at risk during aneurysm surgery. METHODS: A microdialysis catheter was inserted under direct vision into at-risk cortex at the start of surgery. This monitoring was sustained throughout the course of the operation, during which intraoperative events, for example, temporary arterial occlusion or lobe retraction, were precisely documented. A continuous online flow of dialysate was fed into a mobile bedside glucose and lactate analyser. This comprises flow-injection dual-assay enzyme-based biosensors capable of determining values of metabolites every 30 seconds. RESULTS: Eight patients underwent clipping or wrapping of intracranial aneurysms and were monitored. Time between events and detection: 9 minutes. Mean change in metabolite value +/- standard deviation: temporal lobe retraction lactate, +656 +/- 562 micromol/L (n = 7, P < 0.05); glucose, -123 +/- 138 micromol/L (n = 6, P = 0.08). Glucose intravenous bolus infusion glucose, +512 +/- 244 micromol/L (n = 5, P < 0.01); peak at mean time after bolus, 16 minutes. Temporary proximal clip lactate, +731 +/- 346 micromol/L (n = 6, P < 0.01); glucose, -139 +/- 96 micromol/L (n = 5, P < 0.05); mean clip time, 8.6 minutes. CONCLUSION: The technique detects changes 9 minutes after intraoperative events occur (limited only by probe-to-sensor tubing length and dialysate flow rate). This provides reliable information to the surgeon and anesthetist promptly. It is a useful method for monitoring glucose and lactate in dialysate, particularly when rapid, transient changes in brain analyte levels need to be determined and the alternative offline methodology would be inadequate.
OBJECTIVE: To introduce rapid-sampling microdialysis for the early detection of adverse metabolic changes in tissue at risk during aneurysm surgery. METHODS: A microdialysis catheter was inserted under direct vision into at-risk cortex at the start of surgery. This monitoring was sustained throughout the course of the operation, during which intraoperative events, for example, temporary arterial occlusion or lobe retraction, were precisely documented. A continuous online flow of dialysate was fed into a mobile bedside glucose and lactate analyser. This comprises flow-injection dual-assay enzyme-based biosensors capable of determining values of metabolites every 30 seconds. RESULTS: Eight patients underwent clipping or wrapping of intracranial aneurysms and were monitored. Time between events and detection: 9 minutes. Mean change in metabolite value +/- standard deviation: temporal lobe retraction lactate, +656 +/- 562 micromol/L (n = 7, P < 0.05); glucose, -123 +/- 138 micromol/L (n = 6, P = 0.08). Glucose intravenous bolus infusion glucose, +512 +/- 244 micromol/L (n = 5, P < 0.01); peak at mean time after bolus, 16 minutes. Temporary proximal clip lactate, +731 +/- 346 micromol/L (n = 6, P < 0.01); glucose, -139 +/- 96 micromol/L (n = 5, P < 0.05); mean clip time, 8.6 minutes. CONCLUSION: The technique detects changes 9 minutes after intraoperative events occur (limited only by probe-to-sensor tubing length and dialysate flow rate). This provides reliable information to the surgeon and anesthetist promptly. It is a useful method for monitoring glucose and lactate in dialysate, particularly when rapid, transient changes in brain analyte levels need to be determined and the alternative offline methodology would be inadequate.
Authors: Delphine Feuerstein; Andrew Manning; Parastoo Hashemi; Robin Bhatia; Martin Fabricius; Christos Tolias; Clemens Pahl; Max Ervine; Anthony J Strong; Martyn G Boutelle Journal: J Cereb Blood Flow Metab Date: 2010-02-10 Impact factor: 6.200
Authors: M L Rogers; P A Brennan; C L Leong; S A N Gowers; T Aldridge; T K Mellor; M G Boutelle Journal: Anal Bioanal Chem Date: 2013-02-26 Impact factor: 4.142
Authors: Isabelle C Samper; Sally A N Gowers; Michelle L Rogers; De-Shaine R K Murray; Sharon L Jewell; Clemens Pahl; Anthony J Strong; Martyn G Boutelle Journal: Lab Chip Date: 2019-05-16 Impact factor: 7.517
Authors: Peter J Hutchinson; Ibrahim Jalloh; Adel Helmy; Keri L H Carpenter; Elham Rostami; Bo-Michael Bellander; Martyn G Boutelle; Jeff W Chen; Jan Claassen; Claire Dahyot-Fizelier; Per Enblad; Clare N Gallagher; Raimund Helbok; Lars Hillered; Peter D Le Roux; Sandra Magnoni; Halinder S Mangat; David K Menon; Carl-Henrik Nordström; Kristine H O'Phelan; Mauro Oddo; Jon Perez Barcena; Claudia Robertson; Elisabeth Ronne-Engström; Juan Sahuquillo; Martin Smith; Nino Stocchetti; Antonio Belli; T Adrian Carpenter; Jonathan P Coles; Marek Czosnyka; Nil Dizdar; J Clay Goodman; Arun K Gupta; Troels H Nielsen; Niklas Marklund; Ambroise Montcriol; Mark T O'Connell; Maria A Poca; Asita Sarrafzadeh; Richard J Shannon; Jane Skjøth-Rasmussen; Peter Smielewski; John F Stover; Ivan Timofeev; Paul Vespa; Elizabeth Zavala; Urban Ungerstedt Journal: Intensive Care Med Date: 2015-09 Impact factor: 17.440