Intracerebral monitoring of oxidative stress for acute brain injury using microdialysis

本研究采用脑微透析法对创伤性脑损伤(TBI)或心脏骤停综合征(PCAS)患者的神经化学变化进行了研究。在颅脑损伤中，乳酸/丙酮酸比值的大幅波动表明预后不良，可能与皮质铺展抑制有关。60 mm Hg以下脑灌注压(CPP)降低与颅脑损伤后MD甘油升高、MD血糖降低有关。在CPA患者中，每次静脉注射甘油(渗透性利尿剂)后，MD甘油立即和一过性升高，特别是在预后较差的病例。60 mm Hg以下CPP降低与CPA中MD-Glu升高有关。CPA时，血浆乳酸和血糖分别与MD乳酸和MD葡萄糖相关。脑内的MD参数值必须结合系统参数和MD探头的位置(脑损伤的严重程度)进行分析。

This study evaluates the neurochemical changes in patients with traumatic brain injury (TBI) or post cardiac arrest syndrome (PCAS) using brain microdialysis. In TBI, large fluctuation of lactate/pyruvate ratio indicating poor outcome may related to cortical spreading depression. Lower cerebral perfusion pressure (CPP) under 60 mmHg relates increase of MD glycerol and decrease of MD glucose in TBI. In CPA patients, MD glycerol rose immediately and transiently after every intravenous glycerol (osmotic diuretic) administration, especially in poor outcome case. Lower CPP under 60 mmHg relates increase of MD glutamate in CPA. Plasma lactate and glucose relates MD lactate and MD glucose, respectively in CPA. Intracerebral MD parameter values must be analyzed with systemic parameters and the location of MD probe (the severity of the brain damage).