Authors' objectives:

The purpose of this report is to summarize current literature on the efficacy and safety of cerebral microdialysis (CMD) - a method for sampling biochemical markers of secondary brain damage from cerebral interstitial tissue fluid, among traumatic brain injury (TBI) patients.

Authors' results and conclusions: 19 articles satisfied the inclusion criteria, of which 13 studies had a sample size less than 50. The most commonly evaluated clinical outcomes were: death and clinical status using the Glasgow outcome scale following discharge from hospital. Most studies evaluated the association between CMD results and simultaneously measured markers of cerebral ischemia such as hypoxia, intracranial hypertension, systemic hypotension, global oxygen delivery or cerebral blood flow. Though several studies reported observing decreased glucose, increased lactate, increased lactate/pyruvate ratio and increased glutamate in association with an adverse event as measured by either clinical outcomes or markers of cerebral ischemia, these results was not consistent across studies. One study reported that this pattern was noticed in the absence of any adverse event in a small group of patients.

Authors' recommendations: There is some evidence in these studies that cerebral metabolic abnormalities revealed by CMD may correlate with evidence of certain potential causes of cerebral ischemia and with adverse clinical outcomes. The available literature does not provide sufficient proof of the efficacy of CMD as a predictor of clinical outcomes to justify its introduction as a clinical monitoring procedure in TBI patients. It has yet to be evaluated using established methods for evaluation of a diagnostic modality. Thus, while CMD may be a procedure with some research promise, it is not yet a clinically applicable tool.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://upload.mcgill.ca/tau/CEREBRAL_MICRODIALYSIS_FINAL.pdf

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Technology Assessment Unit of the McGill University Health Centre (MUHC)

Contact Address: Technology Assessment Unit of the MUHC, Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, 5252 boul. de Maisonneuve, Bureau 3F.50, Montreal, Quebec H4A 3S5

Contact Name: nandini.dendukuri@mcgill.ca

Contact Email: nandini.dendukuri@mcgill.ca

Copyright: Technology Assessment Unit of the McGill University Health Centre (MUHC)