Monitoring Neurochemistry in Traumatic Brain Injury Patients Using Microdialysis Integrated with Biosensors: A Review.

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Carpenter, Keri LH 
Hutchinson, Peter J 

In a traumatically injured brain, the cerebral microdialysis technique allows continuous sampling of fluid from the brain's extracellular space. The retrieved brain fluid contains useful metabolites that indicate the brain's energy state. Assessment of these metabolites along with other parameters, such as intracranial pressure, brain tissue oxygenation, and cerebral perfusion pressure, may help inform clinical decision making, guide medical treatments, and aid in the prognostication of patient outcomes. Currently, brain metabolites are assayed on bedside analysers and results can only be achieved hourly. This is a major drawback because critical information within each hour is lost. To address this, recent advances have focussed on developing biosensing techniques for integration with microdialysis to achieve continuous online monitoring. In this review, we discuss progress in this field, focusing on various types of sensing devices and their ability to quantify specific cerebral metabolites at clinically relevant concentrations. Important points that require further investigation are highlighted, and comments on future perspectives are provided.

biosensors, cerebral metabolism, cerebral microdialysis, neurochemistry, traumatic brain injury
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Cambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
National Institute for Health Research Invention for Innovation Awards (NIHR i4i Challenge Award and NIHR i4i Product Development Award) and the NIHR Brain Injury MedTech Co-operative. C.Z. is supported by a Research Studentship from the W.D. Armstrong Trust (Uni-versity of Cambridge). F.C.A. is supported by an NIHR i4i Product Development Award. K.L.H.C. is supported by the NIHR Biomedical Research Centre, Cambridge and by an NIHR i4i Product Development Award. P.J.H. is supported by the NIHR Biomedical Research Centre Cambridge, NIHR Senior Investigator Award, and the Royal College of Surgeons of England.