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Dexamethasone-Enhanced Continuous Online Microdialysis for Neuromonitoring of O₂ after Brain Injury.

ABSTRACT: Traumatic brain injury (TBI) is a major public health crisis in many regions of the world. Severe TBI may cause a primary brain lesion with a surrounding penumbra of tissue that is vulnerable to secondary injury. Secondary injury presents as progressive expansion of the lesion, possibly leading to severe disability, a persistent vegetive state, or death. Real time neuromonitoring to detect and monitor secondary injury is urgently needed. Dexamethasone-enhanced continuous online microdialysis (Dex-enhanced coMD) is an emerging paradigm for chronic neuromonitoring after brain injury. The present study employed Dex-enhanced coMD to monitor brain K⁺ and O₂ during manually induced spreading depolarization in the cortex of anesthetized rats and after controlled cortical impact, a widely used rodent model of TBI, in behaving rats. Consistent with prior reports on glucose, O₂ exhibited a variety of responses to spreading depolarization and a prolonged, essentially permanent decline in the days after controlled cortical impact. These findings confirm that Dex-enhanced coMD delivers valuable information regarding the impact of spreading depolarization and controlled cortical impact on O₂ levels in the rat cortex.

SUBMITTER: Robbins EM

PROVIDER: S-EPMC10360069 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Dexamethasone-Enhanced Continuous Online Microdialysis for Neuromonitoring of O<sub>2</sub> after Brain Injury.

Robbins Elaine M EM Jaquins-Gerstl Andrea S AS Okonkwo David O DO Boutelle Martyn G MG Michael Adrian C AC

ACS chemical neuroscience 20230627 14

Traumatic brain injury (TBI) is a major public health crisis in many regions of the world. Severe TBI may cause a primary brain lesion with a surrounding penumbra of tissue that is vulnerable to secondary injury. Secondary injury presents as progressive expansion of the lesion, possibly leading to severe disability, a persistent vegetive state, or death. Real time neuromonitoring to detect and monitor secondary injury is urgently needed. Dexamethasone-enhanced continuous online microdialysis (De ...[more]

PMID: 37369003

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Project description:BackgroundContinuous intraoperative neuromonitoring has successfully demonstrated to predict impending damage to the recurrent laryngeal nerve, by detecting changes in electromyographic recordings. Despite the apparent benefits associated with continuous intraoperative neuromonitoring, its safety is still a debate. The aim of this study was to investigate the electrophysiological impact of continuous intraoperative neuromonitoring on the vagus nerve.MethodsIn this prospective study, the amplitude of the electromyographic wave of the vagus nerve-recurrent laryngeal nerve axis was measured both proximally and distally to the stimulation electrode placed upon the vagus nerve. Electromyographic signal amplitudes were collected at three distinct events during the operation: during the dissection of the vagus nerve, before application of the continuous stimulation electrode onto the vagus nerve and after its removal.ResultsIn total, 169 vagus nerves were analysed, among 108 included patients undergoing continuous intraoperative neuromonitoring-enhanced endocrine neck surgeries. Electrode application resulted in a significant overall decrease in measured proximo-distal amplitudes of -10.94 µV (95 per cent c.i. -17.06 to -4.82 µV) (P < 0.005), corresponding to a mean(s.d.) decrease of -1.4(5.4) per cent. Before the removal of the electrode, the measured proximo-distal difference in amplitudes was -18.58 µV (95 per cent c.i. -28.31 to -8.86 µV) (P < 0.005), corresponding to a mean(s.d.) decrease of -2.50(9.59) per cent. Seven nerves suffered a loss of amplitude greater than 20 per cent of the baseline measurement.ConclusionIn addition to supporting claims that continuous intraoperative neuromonitoring exposes the vagus nerve to injury, this study shows a mild electrophysiological impact of continuous intraoperative neuromonitoring electrode placement on the vagus nerve-recurrent laryngeal nerve axis. However, the small observed differences are negligible and were not associated with a clinically relevant outcome, making continuous intraoperative neuromonitoring a safe adjunct in selected thyroid surgeries.

Dataset Information

Dexamethasone-Enhanced Continuous Online Microdialysis for Neuromonitoring of O₂ after Brain Injury.

Publications

Dexamethasone-Enhanced Continuous Online Microdialysis for Neuromonitoring of O<sub>2</sub> after Brain Injury.

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Dataset Information

Dexamethasone-Enhanced Continuous Online Microdialysis for Neuromonitoring of O2 after Brain Injury.

Publications

Dexamethasone-Enhanced Continuous Online Microdialysis for Neuromonitoring of O<sub>2</sub> after Brain Injury.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dexamethasone-Enhanced Continuous Online Microdialysis for Neuromonitoring of O₂ after Brain Injury.