Clinical cerebral microdialysis: a methodological study

Peter J. Hutchinson Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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Mark T. O'Connell Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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 Ph.D.
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Pippa G. Al-Rawi Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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 B.Sc.
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Lynn B. Maskell Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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Rupert Kett-White Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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Arun K. Gupta Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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Hugh K. Richards Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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David B. Hutchinson Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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Peter J. Kirkpatrick Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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John D. Pickard Academic Department of Neurosurgery and Wolfson Brain Imaging Centre, Department of Neurointensive Care and Medical Research Council Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom

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Page Range:
37–43
Volume/Issue:
Volume 93: Issue 1
DOI link:
https://doi.org/10.3171/jns.2000.93.1.0037
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Object. Clinical microdialysis enables monitoring of the cerebral extracellular chemistry of neurosurgical patients. Introduction of the technique into different hospitals' neurosurgical units has resulted in variations in the method of application. There are several variables to be considered, including length of the catheter membrane, type of perfusion fluid, flow rate of perfusion fluid, and on-line compared with delayed analysis of samples. The objects of this study were as follows: 1) to determine the effects of varying catheter characteristics on substance concentration; 2) to determine the relative recovery and true extracellular concentration by varying the flow rate and extrapolating to zero flow; and 3) to compare substance concentration obtained using a bedside enzyme analyzer with that of off-line high-performance liquid chromatography (HPLC).

Methods. A specially designed bolt was used to conduct two adjacent microdialysis catheters into the frontal cortex of patients with head injury or poor-grade subarachnoid hemorrhage who were receiving ventilation. One reference catheter (10-mm membrane, perfused with Ringer's solution at 0.3 µl/minute) was constant for all studies. The other catheter was varied in terms of membrane length (10 mm or 30 mm), perfusion fluid (Ringer's solution or normal saline), and flow rate (0.1–1.5 µl/minute). The effect of freezing the samples on substance concentration was established by on-line analysis and then repeated analysis after storage at −70°C for 3 months. Samples assayed with the bedside enzyme analyzer were reassessed using HPLC for the determination of glutamate concentrations.

Conclusions. Two adjacent microdialysis catheters that were identical in membrane length, perfusion fluid, and flow rate showed equivalent results. Variations in perfusion fluid and freezing and thawing of samples did not result in differences in substance concentration. Catheter length had a significant impact on substance recovery. Variations in flow rate enabled the relative recovery to be calculated using a modification of the extrapolation-to-zero-flow method. The recovery was approximately 70% at 0.3 µl/minute and 30% at 1 µl/minute (10-mm membrane) for all analytes. Glutamate results obtained with the enzyme analyzer showed good correlation with those from HPLC.

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Contributor Notes

Address reprint requests to: Peter J. Hutchinson, F.R.C.S., Academic Department of Neurosurgery, University of Cambridge, Box 167, Addenbrooke's Hospital, Cambridge, CB2 2QQ United Kingdom. email: Peter.Hutchinson@dial.pipex.com.
  • 1.

    Anonymous: Microdialysis. Lancet 339:1326–1327, 1992 (Editorial) Anonymous: Microdialysis. Lancet 339:1326–1327, 1992 (Editorial)

  • 2.

    Bachli H, , Langemann H, & Mendelowitsch A, et al: Microdialytic monitoring during cerebrovascular surgery. Neurol Res 18:370–376, 1996 Bachli H, Langemann H, Mendelowitsch A, et al: Microdialytic monitoring during cerebrovascular surgery. Neurol Res 18:370–376, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Benveniste H: Brain microdialysis. J Neurochem 52:1667–1679, 1989 Benveniste H: Brain microdialysis. J Neurochem 52:1667–1679, 1989

  • 4.

    Benveniste H, , Hansen AJ, & Ottoson NS: Determination of brain interstitial concentrations by microdialysis. J Neurochem 52:1741–1750, 1989 Benveniste H, Hansen AJ, Ottoson NS: Determination of brain interstitial concentrations by microdialysis. J Neurochem 52:1741–1750, 1989

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Bullock R, , Zauner A, & Woodward JJ, et al: Factors affecting excitatory amino acid release following severe human head injury. J Neurosurg 89:507–518, 1998 Bullock R, Zauner A, Woodward JJ, et al: Factors affecting excitatory amino acid release following severe human head injury. J Neurosurg 89:507–518, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Delgado JMR, , DeFeudis FV, & Roth RH, et al: Dialytrode for long term intracerebral perfusion in awake monkeys. Arch Int Pharmacodyn Ther 198:9–21, 1972 Delgado JMR, DeFeudis FV, Roth RH, et al: Dialytrode for long term intracerebral perfusion in awake monkeys. Arch Int Pharmacodyn Ther 198:9–21, 1972

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    During MJ, & Spencer DD: Extracellular hippocampal glutamate and spontaneous seizure in the conscious human brain. Lancet 341:1607–1610, 1993 During MJ, Spencer DD: Extracellular hippocampal glutamate and spontaneous seizure in the conscious human brain. Lancet 341:1607–1610, 1993

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Fray AE, , Boutelle M, & Fillenz M: Extracellular glucose turnover in the striatum of unanaesthetized rats measured by quantititative microdialysis. J Physiol 504:721–726, 1997 Fray AE, Boutelle M, Fillenz M: Extracellular glucose turnover in the striatum of unanaesthetized rats measured by quantititative microdialysis. J Physiol 504:721–726, 1997

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Fried I, , Wilson CL, & Maidment NT, et al: Cerebral microdialysis combined with single-neuron and electroencephalographic recording in neurosurgical patients. Technical note. J Neurosurg 91:697–705, 1999 Fried I, Wilson CL, Maidment NT, et al: Cerebral microdialysis combined with single-neuron and electroencephalographic recording in neurosurgical patients. Technical note. J Neurosurg 91:697–705, 1999

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Goodman JC, , Gopinath SP, & Valadka AB, et al: Lactic acid and amino acid fluctuations measured using microdialysis reflect physiological derangements in head injury. Acta Neurochir Suppl 67:37–39, 1996 Goodman JC, Gopinath SP, Valadka AB, et al: Lactic acid and amino acid fluctuations measured using microdialysis reflect physiological derangements in head injury. Acta Neurochir Suppl 67:37–39, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Hamberger A, , Jacobson I, & Nyström B, et al: Microdialysis sampling of the neuronal environment in basic and clinical research. J Intern Med 230:375–380, 1991 Hamberger A, Jacobson I, Nyström B, et al: Microdialysis sampling of the neuronal environment in basic and clinical research. J Intern Med 230:375–380, 1991

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Hamberger A, , Nystrom B, & Larsson S, et al: Amino acids in the neuronal microenvironment of focal human epileptic lesions. Epilepsy Res 9:32–43, 1991 Hamberger A, Nystrom B, Larsson S, et al: Amino acids in the neuronal microenvironment of focal human epileptic lesions. Epilepsy Res 9:32–43, 1991

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Hutchinson PJ, , Al-Rawi PG, & O'Connell MT, et al: Monitoring of brain metabolism during aneurysm surgery using microdialysis and brain multiparameter sensors. Neurol Res 21:352–358, 1999 Hutchinson PJ, Al-Rawi PG, O'Connell MT, et al: Monitoring of brain metabolism during aneurysm surgery using microdialysis and brain multiparameter sensors. Neurol Res 21:352–358, 1999

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Hutchinson PJA, , O'Connell MT, & Al-Rawi P, et al: Intracerebral monitoring in severe head injury—intracranial pressure, paratrend sensor and microdialysis using a new triple bolt. Br J Neurosurg 12:87P, 1998 Hutchinson PJA, O'Connell MT, Al-Rawi P, et al: Intracerebral monitoring in severe head injury—intracranial pressure, paratrend sensor and microdialysis using a new triple bolt. Br J Neurosurg 12:87P, 1998

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Jacobson I, , Sandberg M, & Hamberger A: Mass transfer in brain dialysis devices—a new method for the estimation of extracellular amino acids concentration. J Neurosci Methods 15:263–268, 1985 Jacobson I, Sandberg M, Hamberger A: Mass transfer in brain dialysis devices—a new method for the estimation of extracellular amino acids concentration. J Neurosci Methods 15:263–268, 1985

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Kehr J: A survey on quantitative microdialysis: theoretical models and practical implications. J Neurosci Methods 48:251–261, 1993 Kehr J: A survey on quantitative microdialysis: theoretical models and practical implications. J Neurosci Methods 48:251–261, 1993

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Langemann H, , Alessandri B, & Landholt H, et al: True levels of glucose and lactate measured by microdialysis in the cerebral extracellular fluid of patients, in González-Mora JL, , Guadalupe T, & Pérez de la Cruz MA (eds): Monitoring Molecules in Neuroscience. La Laguna: University of La Laguna, 1996, pp 397–399 Langemann H, Alessandri B, Landholt H, et al: True levels of glucose and lactate measured by microdialysis in the cerebral extracellular fluid of patients, in González-Mora JL, Guadalupe T, Pérez de la Cruz MA (eds): Monitoring Molecules in Neuroscience. La Laguna: University of La Laguna, 1996, pp 397–399

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Lonnroth P, , Jannson PA, & Smith U: A microdialysis method allowing characterization of intracellular water space in humans. Am J Physiol 253:E228–E231, 1987 Lonnroth P, Jannson PA, Smith U: A microdialysis method allowing characterization of intracellular water space in humans. Am J Physiol 253:E228–E231, 1987

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Menacherry S, , Hubert W, & Justice JB Jr: In vivo calibration of microdialysis probes for exogenous compounds. Anal Chem 64:577–583, 1992 Menacherry S, Hubert W, Justice JB Jr: In vivo calibration of microdialysis probes for exogenous compounds. Anal Chem 64:577–583, 1992

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Mendelowitsch A, , Langemann H, & Alessandri B, et al: Microdialytic monitoring of the cortex during neurovascular surgery. Acta Neurochir Suppl 67:48–52, 1996 Mendelowitsch A, Langemann H, Alessandri B, et al: Microdialytic monitoring of the cortex during neurovascular surgery. Acta Neurochir Suppl 67:48–52, 1996

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Menzel M, , Doppenberg EM, & Zauner A, et al: Increased inspired oxygen concentration as a factor in improved brain tissue oxygenation and tissue lactate levels after severe human head injury. J Neurosurg 91:1–10, 1999 Menzel M, Doppenberg EM, Zauner A, et al: Increased inspired oxygen concentration as a factor in improved brain tissue oxygenation and tissue lactate levels after severe human head injury. J Neurosurg 91:1–10, 1999

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Meyerson BA, , Linderoth B, & Karlsson H, et al: Microdialysis in the human brain: extracellular measurements in the thalamus of Parkinsonian patients. Life Sci 46:301–308, 1990 Meyerson BA, Linderoth B, Karlsson H, et al: Microdialysis in the human brain: extracellular measurements in the thalamus of Parkinsonian patients. Life Sci 46:301–308, 1990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Moghaddam B, & Bunney BS: Ionic composition of microdialysis perfusing solution alters the pharmacological responsiveness and basal outflow of striatal dopamine. J Neurochem 53:652–654, 1989 Moghaddam B, Bunney BS: Ionic composition of microdialysis perfusing solution alters the pharmacological responsiveness and basal outflow of striatal dopamine. J Neurochem 53:652–654, 1989

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Nicholson C, & Phillips JM: Ion diffusion modified by tortuosity and volume fraction in the extracellular microenvironment of the rat cerebellum. J Physiol (Lond) 321:225–257, 1981 Nicholson C, Phillips JM: Ion diffusion modified by tortuosity and volume fraction in the extracellular microenvironment of the rat cerebellum. J Physiol (Lond) 321:225–257, 1981

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Nicholson C, & Rice ME: The migration of substances in the neuronal microenvironment. Ann NY Acad Sci 481:55–71, 1986 Nicholson C, Rice ME: The migration of substances in the neuronal microenvironment. Ann NY Acad Sci 481:55–71, 1986

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Persson L, & Hillered L: Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis. J Neurosurg 76:72–80, 1992 Persson L, Hillered L: Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis. J Neurosurg 76:72–80, 1992

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Persson L, , Valtysson J, & Enblad P, et al: Neurochemical monitoring using intracerebral microdialysis in patients with subarachnoid hemorrhage. J Neurosurg 84:606–616, 1996 Persson L, Valtysson J, Enblad P, et al: Neurochemical monitoring using intracerebral microdialysis in patients with subarachnoid hemorrhage. J Neurosurg 84:606–616, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Robertson CS, , Gopinath SP, & Uzura M, et al: Metabolic changes in the brain during transient ischemia measured with microdialysis. Neurol Res 20 (Suppl 1):S91–S94, 1998 Robertson CS, Gopinath SP, Uzura M, et al: Metabolic changes in the brain during transient ischemia measured with microdialysis. Neurol Res 20 (Suppl 1):S91–S94, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Ronne-Engstrom E, , Hillered L, & Flink R, et al: Intracerebral microdialysis of extracellular amino acids in the human epileptic focus. J Cereb Blood Flow Metab 12:873–876, 1992 Ronne-Engstrom E, Hillered L, Flink R, et al: Intracerebral microdialysis of extracellular amino acids in the human epileptic focus. J Cereb Blood Flow Metab 12:873–876, 1992

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Säveland H, , Nilsson OG, & Boris-Möller F, et al: Intracerebral microdialysis of glutamate and aspartate in two vascular territories after aneurysmal subarachnoid haemorrhage. Neurosurgery 38:12–20, 1996 Säveland H, Nilsson OG, Boris-Möller F, et al: Intracerebral microdialysis of glutamate and aspartate in two vascular territories after aneurysmal subarachnoid haemorrhage. Neurosurgery 38:12–20, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Ungerstedt U: Measurement of neurotransmitter release by intracranial dialysis, in Marsden CA (ed): Measurement of Neurotransmitter Release in Vivo. Chichester: Wiley, 1984, pp 81–105 Ungerstedt U: Measurement of neurotransmitter release by intracranial dialysis, in Marsden CA (ed): Measurement of Neurotransmitter Release in Vivo. Chichester: Wiley, 1984, pp 81–105

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Ungerstedt U: Microdialysis—principles and applications for studies in animals and man. J Intern Med 230:365–373, 1991 Ungerstedt U: Microdialysis—principles and applications for studies in animals and man. J Intern Med 230:365–373, 1991

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Vespa PM, , Prins M, & Ronne-Engstrom E, et al: Increase in extracellular glutamate caused by reduced cerebral perfusion pressure and seizures after human traumatic brain injury: a microdialysis study. J Neurosurg 89:971–982, 1998 Vespa PM, Prins M, Ronne-Engstrom E, et al: Increase in extracellular glutamate caused by reduced cerebral perfusion pressure and seizures after human traumatic brain injury: a microdialysis study. J Neurosurg 89:971–982, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Whittle IR: Intracerebral microdialysis: a new method in applied clinical neuroscience research. Br J Neurosurg 4:459–462, 1990 Whittle IR: Intracerebral microdialysis: a new method in applied clinical neuroscience research. Br J Neurosurg 4:459–462, 1990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Zauner A, , Doppenberg EMR, & Woodward JJ, et al: Continuous monitoring of cerebral substrate delivery and clearance: initial experience in 24 patients with severe acute brain injuries. Neurosurgery 41:1082–1093, 1997 Zauner A, Doppenberg EMR, Woodward JJ, et al: Continuous monitoring of cerebral substrate delivery and clearance: initial experience in 24 patients with severe acute brain injuries. Neurosurgery 41:1082–1093, 1997

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

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