Technical enhancements for intracranial microdialysis

自20世纪70年代以来，颅内微透析已在人类患者中进行，但尚未 已被采用或批准作为诊断技术。 迫切需要加强 具有诊断能力的微透析技术。 微透析是目前唯一 该技术具有检测两个关键化学标志物葡萄糖和钾的能力 结论：重型颅脑损伤患者继发性脑损伤的发生率高。 诊断 二次损伤是关键的，因为它是不良结果的主要原因（严重残疾， 植物人状态和死亡），即使是那些在受伤、手术和几天后幸存下来的患者， 重症监护室 直到最近，在探针轨道的胶质细胞增生严重限制了性能 微透析的能力。 然而，在灌注液中加入地塞米松已经证明， 简单而高效的抑制神经胶质增生的方法。地塞米松使我们能够 最近检测到大鼠大脑皮层中葡萄糖和钾的畸变， 通过可控的皮质撞击造成损伤 在此，我们建议探索三个额外的新颖和重要的技术增强， 颅内微透析是建立在我们最近成功基础上的 首先，我们建议探索 透析膜的纳米级改性作为地塞米松的替代品，因为 可能出现排除使用地塞米松的情况。 第二，我们建议探索 葡萄糖递送作为逆转大鼠大脑中葡萄糖缺乏的手段， 影响：这项工作将为继发性脑损伤的新疗法奠定基础。 第三，在寻找继发性损伤的新化学标志物时，我们将探索大规模的 脑透析液的光谱分析作为来自 个脑袋

Intracranial microdialysis has been performed in human patients since the 1970s but has not yet been adopted or approved as a diagnostic technology. There is an urgent need for enhanced microdialysis technology with diagnostic capabilities. Microdialysis is the only existing technology with the demonstrated ability to detect two key chemical markers, glucose and potassium ion, of secondary brain injury in patients with severe traumatic brain injury. Diagnosis of secondary injury is critical because it is a major contributor to poor outcomes (severe disability, vegetative state, and death) even for patients who survive their injury, surgery, and several days of intensive care. Until recently, gliosis at the probe track has severely limited the performance capabilities of microdialysis. Adding dexamethasone to the perfusion fluid, however, has proven a simple yet highly effective approach to suppressing gliosis. Dexamethasone has enabled us to recently detect aberrations of glucose and potassium in the cortex of the rat brain 11 days after inducing an injury by controlled cortical impact. Herein, we propose to explore three additional novel and significant technical enhancements for intracranial microdialysis that build on our recent successes. First, we propose to explore nano-scale modifications of the dialysis membrane as an alternative to dexamethasone, because circumstances may arise that preclude the use of dexamethasone. Second, we propose to explore glucose delivery as a means to reverse glucose deficits in the rat brain after controlled cortical impact: this work will establish the foundation for a novel therapy for secondary brain injury. Third, in a search for novel chemical markers for secondary injury, we will explore mass spectrometric analysis of brain dialysate as a source of orthogonal chemical information from the brain.