Abstract Details

Title Cerebral Microdialysis Probe Location as an Indicator of Metabolic Distress in Traumatic Brain Injury.

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Neurocritical Care Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 023

Objective

Demonstrate the importance of cerebral microdialysis (CMD) probe location as a critical factor in determining early signs of cerebral metabolic distress (MDS) following traumatic brain injury (TBI).

Background

CMD is utilized for semi-continuous monitoring of cerebral metabolism, but data are limited regarding the influence of probe location for early detection of MDS.

Design/Methods

In this retrospective, single institution study, we obtained data from 13 TBI patients using CMA-600 analyzer. CMD probes were placed in different locations relative to the lesion site. Analysis of variance adjusting for repeated measures was performed to determine differences in lactate-pyruvate ratio (LPR) and glucose levels between intralesional vs perilesional vs contralateral lesions. MDS was defined as at least two consecutive hours with LPR>40 and glucose <0.8 mmol/L. Average time in metabolic distress was calculated.

Results Six patients had intralesional probe placement, four perilesional, and three contralateral. The groups did not differ with respect to age or gender. There was no difference in mean LPR between the intralesional, perilesional, and contralateral groups (30.6, 22, 27.9, respectively, F value=0.13, p=0.72). Median glucose (mmol/L) was also not significantly different (1 vs 1.7 vs 2.1 respectively, F value=0.6, p=0.45). Of those who experienced MDS, contralateral probe monitoring resulted in shorter mean consecutive MDS time (hours) compared those who had intralesional monitoring (30.3 vs. 98, one-tailed t-test, p=0.14). No patients with perilesional placement exhibited evidence of MDS.

Conclusions In our small retrospective cohort, we found no differences in LPR or glucose levels in relation to microdialysis probe location. Intralesional probe placement had a trend towards longer duration of MDS compared to contralateral placement. Further investigation with larger sample size is warranted.

Authors/Disclosures
Jude H. Charles, MD PRESENTER	Dr. Charles has nothing to disclose.
Ritwik Bhatia, MD (University of California, San Francisco, Dept of Neurology)	Dr. Bhatia has nothing to disclose.
Joshua Lukas, MD (Riverside Methodist Hospital (Ohio Health))	Dr. Lukas has nothing to disclose.
Ayham M. Alkhachroum, MD (Columbia University Medical Center)	The institution of Dr. Alkhachroum has received research support from Miami CTSI.
Kristine H. O'Phelan, MD (University of Miami)	Dr. O'Phelan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bard Medical. Dr. O'Phelan has a non-compensated relationship as a DSMB member SIREN network with NIH/NINDS that is relevant to AAN interests or activities.

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