Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest

Abstract Bedside detection and early treatment of lasting cerebral ischemia may improve outcome after out-of-hospital cardiac arrest (OHCA). This feasibility study explores the possibilities to use microdialysis (MD) for continuous monitoring of cerebral energy metabolism by analyzing the draining c...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Simon Mölström, Troels Halfeld Nielsen, Carl H. Nordström, Axel Forsse, Sören Möller, Sören Venö, Dmitry Mamaev, Tomas Tencer, Henrik Schmidt, Palle Toft
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4e9305491e774039b5c49cde77e3510d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4e9305491e774039b5c49cde77e3510d
record_format	dspace
spelling	oai:doaj.org-article:4e9305491e774039b5c49cde77e3510d2021-12-02T17:06:08ZBedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest10.1038/s41598-021-95405-92045-2322https://doaj.org/article/4e9305491e774039b5c49cde77e3510d2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95405-9https://doaj.org/toc/2045-2322Abstract Bedside detection and early treatment of lasting cerebral ischemia may improve outcome after out-of-hospital cardiac arrest (OHCA). This feasibility study explores the possibilities to use microdialysis (MD) for continuous monitoring of cerebral energy metabolism by analyzing the draining cerebral venous blood. Eighteen comatose patients were continuously monitored with jugular bulb and radial artery (reference) MD following resuscitation. Median time from cardiac arrest to MD was 300 min (IQR 230–390) with median monitoring time 60 h (IQR 40–81). The lactate/pyruvate ratio in cerebral venous blood was increased during the first 20 h after OHCA, and significant differences in time-averaged mean MD metabolites between jugular venous and artery measurements, were documented (p < 0.02). In patients with unfavorable outcome (72%), cerebral venous lactate and pyruvate levels remained elevated during the study period. In conclusion, the study indicates that jugular bulb microdialysis (JBM) is feasible and safe. Biochemical signs of lasting ischemia and mitochondrial dysfunction are frequent and associated with unfavorable outcome. The technique may be used in comatose OHCA patients to monitor biochemical variables reflecting ongoing brain damage and support individualized treatment early after resuscitation.Simon MölströmTroels Halfeld NielsenCarl H. NordströmAxel ForsseSören MöllerSören VenöDmitry MamaevTomas TencerHenrik SchmidtPalle ToftNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Simon Mölström Troels Halfeld Nielsen Carl H. Nordström Axel Forsse Sören Möller Sören Venö Dmitry Mamaev Tomas Tencer Henrik Schmidt Palle Toft Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest
description	Abstract Bedside detection and early treatment of lasting cerebral ischemia may improve outcome after out-of-hospital cardiac arrest (OHCA). This feasibility study explores the possibilities to use microdialysis (MD) for continuous monitoring of cerebral energy metabolism by analyzing the draining cerebral venous blood. Eighteen comatose patients were continuously monitored with jugular bulb and radial artery (reference) MD following resuscitation. Median time from cardiac arrest to MD was 300 min (IQR 230–390) with median monitoring time 60 h (IQR 40–81). The lactate/pyruvate ratio in cerebral venous blood was increased during the first 20 h after OHCA, and significant differences in time-averaged mean MD metabolites between jugular venous and artery measurements, were documented (p < 0.02). In patients with unfavorable outcome (72%), cerebral venous lactate and pyruvate levels remained elevated during the study period. In conclusion, the study indicates that jugular bulb microdialysis (JBM) is feasible and safe. Biochemical signs of lasting ischemia and mitochondrial dysfunction are frequent and associated with unfavorable outcome. The technique may be used in comatose OHCA patients to monitor biochemical variables reflecting ongoing brain damage and support individualized treatment early after resuscitation.
format	article
author	Simon Mölström Troels Halfeld Nielsen Carl H. Nordström Axel Forsse Sören Möller Sören Venö Dmitry Mamaev Tomas Tencer Henrik Schmidt Palle Toft
author_facet	Simon Mölström Troels Halfeld Nielsen Carl H. Nordström Axel Forsse Sören Möller Sören Venö Dmitry Mamaev Tomas Tencer Henrik Schmidt Palle Toft
author_sort	Simon Mölström
title	Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest
title_short	Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest
title_full	Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest
title_fullStr	Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest
title_full_unstemmed	Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest
title_sort	bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4e9305491e774039b5c49cde77e3510d
work_keys_str_mv	AT simonmolstrom bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT troelshalfeldnielsen bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT carlhnordstrom bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT axelforsse bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT sorenmoller bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT sorenveno bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT dmitrymamaev bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT tomastencer bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT henrikschmidt bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest AT palletoft bedsidemicrodialysisfordetectionofearlybraininjuryafteroutofhospitalcardiacarrest
_version_	1718381728713670656

Bedside microdialysis for detection of early brain injury after out-of-hospital cardiac arrest

Ejemplares similares