Hillered L, Persson L
Department of Medical Sciences, Uppsala University Hospital, Sweden.
Scand J Clin Lab Invest Suppl. 1999;229:9-18. doi: 10.1080/00365519950185904.
The main goal of modern neurointensive care (NIC) of patients with acute brain injury (traumatic brain injury, neurovascular disease) is to prevent additional loss of viable brain tissue due to secondary injury processes. It is generally held that secondary injury, mediated by, for example, cerebral hypoxia/ischemia and destructive molecular cascades on the cellular level, contributes significantly to the extent of brain damage after head injury and stroke. The basic concept is that improved knowledge of the secondary injury processes will lead to new therapeutic approaches in NIC. New methods by which secondary injury processes can be detected and monitored in NIC patients are therefore greatly needed. This paper describes intracerebral microdialysis as a novel approach to neurochemical monitoring of the human brain. The main objectives are (i) to monitor cortical energy metabolism in order to detect secondary ischemia and (ii) to monitor secondary injury processes, such as glutamate receptor overactivation and increased free radical production, in NIC patients.
现代对急性脑损伤（创伤性脑损伤、神经血管疾病）患者的神经重症监护（NIC）的主要目标是防止由于继发性损伤过程导致存活脑组织的额外损失。一般认为，由例如脑缺氧/缺血和细胞水平上的破坏性分子级联反应介导的继发性损伤，在头部受伤和中风后的脑损伤程度中起显著作用。基本概念是，对继发性损伤过程的深入了解将导致神经重症监护中的新治疗方法。因此，非常需要能够在NIC患者中检测和监测继发性损伤过程的新方法。本文描述了脑内微透析作为一种对人脑进行神经化学监测的新方法。主要目标是：（i）监测皮质能量代谢以检测继发性缺血；（ii）监测NIC患者中的继发性损伤过程，例如谷氨酸受体过度激活和自由基产生增加。
