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Lilleøre JG, Vittrup S, Tøstesen SK, Hanberg P, Stilling M, Bue M. Comparison of Intravenous Microdialysis and Standard Plasma Sampling for Monitoring of Vancomycin and Meropenem Plasma Concentrations-An Experimental Porcine Study. Antibiotics (Basel) 2023; 12:antibiotics12040791. [PMID: 37107154 PMCID: PMC10135263 DOI: 10.3390/antibiotics12040791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Microdialysis is a catheter-based method suitable for dynamic sampling of unbound antibiotic concentrations. Intravenous antibiotic concentration sampling by microdialysis has several advantages and may be a superior alternative to standard plasma sampling. We aimed to compare concentrations obtained by continuous intravenous microdialysis sampling and by standard plasma sampling of both vancomycin and meropenem in a porcine model. Eight female pigs received 1 g of both vancomycin and meropenem, simultaneously over 100 and 10 min, respectively. Prior to drug infusion, an intravenous microdialysis catheter was placed in the subclavian vein. Microdialysates were collected for 8 h. From a central venous catheter, plasma samples were collected in the middle of every dialysate sampling interval. A higher area under the concentration/time curve and peak drug concentration were found in standard plasma samples compared to intravenous microdialysis samples, for both vancomycin and meropenem. Both vancomycin and meropenem concentrations obtained with intravenous microdialysis were generally lower than from standard plasma sampling. The differences in key pharmacokinetic parameters between the two sampling techniques underline the importance of further investigations to find the most suitable and reliable method for continuous intravenous antibiotic concentration sampling.
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Affiliation(s)
- Johanne Gade Lilleøre
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Aarhus Denmark Microdialysis Research Group (ADMIRE), Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Sofus Vittrup
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Aarhus Denmark Microdialysis Research Group (ADMIRE), Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Sara Kousgaard Tøstesen
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Aarhus Denmark Microdialysis Research Group (ADMIRE), Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Pelle Hanberg
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Aarhus Denmark Microdialysis Research Group (ADMIRE), Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Maiken Stilling
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Aarhus Denmark Microdialysis Research Group (ADMIRE), Aarhus University Hospital, 8200 Aarhus, Denmark
- Department of Orthopedic Surgery, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Mats Bue
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Aarhus Denmark Microdialysis Research Group (ADMIRE), Aarhus University Hospital, 8200 Aarhus, Denmark
- Department of Orthopedic Surgery, Aarhus University Hospital, 8200 Aarhus, Denmark
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2
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Qiao B, Nie S, Li Q, Majeed Z, Cheng J, Yuan Z, Li C, Zhao C. Quick and In Situ Detection of Different Polar Allelochemicals in Taxus Soil by Microdialysis Combined with UPLC-MS/MS. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:16435-16445. [PMID: 36512746 DOI: 10.1021/acs.jafc.2c06912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The action of allelopathy need that allelochemicals exist in the soil and reach a certain concentration. Also, the detection of allelochemicals in the soil is one of the most important research topics in the process of exploring allelopathy. To solve the problem of the simultaneous detection of allelochemicals with low concentrations and different polarities, a novel strategy for the quick detection of the allelochemicals in Taxus soil by microdialysis combined with UPLC-MS/MS on the basis of in situ detection without destroying the original structure of soil was developed for the first time in the work. The dialysis conditions were optimized by the Box-Behnken design (BBD): 70% methanol, 3 μL/min flow rate, and 3 cm long membrane tube. A reliable UPLC-MS/MS program was systematically optimized for the simultaneous detection of nine allelochemicals with different polarities. The results proved the differences in the contents and distributions of nine allelochemicals in three different Taxus soils.
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Affiliation(s)
- Bin Qiao
- College of Chemistry, Chemical Engineering and Resource Utilization, Key Laboratory of Forest Plant Ecology, Ministry of Education, Engineering Research Center of Forest Bio-Preparation, Ministry of Education, and Heilongjiang Provincial Key Laboratory of Ecological Utilization of Forestry-based Active Substances, Northeast Forestry University, Harbin150040, China
| | - Siming Nie
- College of Chemistry, Chemical Engineering and Resource Utilization, Key Laboratory of Forest Plant Ecology, Ministry of Education, Engineering Research Center of Forest Bio-Preparation, Ministry of Education, and Heilongjiang Provincial Key Laboratory of Ecological Utilization of Forestry-based Active Substances, Northeast Forestry University, Harbin150040, China
| | - Qianqian Li
- College of Chemistry, Chemical Engineering and Resource Utilization, Key Laboratory of Forest Plant Ecology, Ministry of Education, Engineering Research Center of Forest Bio-Preparation, Ministry of Education, and Heilongjiang Provincial Key Laboratory of Ecological Utilization of Forestry-based Active Substances, Northeast Forestry University, Harbin150040, China
| | - Zahid Majeed
- Department of Biotechnology, The University of Azad Jammu & Kashmir, Muzaffarabad13100, Pakistan
| | - Jiabo Cheng
- College of Chemistry, Chemical Engineering and Resource Utilization, Key Laboratory of Forest Plant Ecology, Ministry of Education, Engineering Research Center of Forest Bio-Preparation, Ministry of Education, and Heilongjiang Provincial Key Laboratory of Ecological Utilization of Forestry-based Active Substances, Northeast Forestry University, Harbin150040, China
| | - Zhanyu Yuan
- Hisun Pharmaceutical (Hangzhou) Co., Ltd., Hangzhou311404, China
| | - Chunying Li
- College of Chemistry, Chemical Engineering and Resource Utilization, Key Laboratory of Forest Plant Ecology, Ministry of Education, Engineering Research Center of Forest Bio-Preparation, Ministry of Education, and Heilongjiang Provincial Key Laboratory of Ecological Utilization of Forestry-based Active Substances, Northeast Forestry University, Harbin150040, China
| | - Chunjian Zhao
- College of Chemistry, Chemical Engineering and Resource Utilization, Key Laboratory of Forest Plant Ecology, Ministry of Education, Engineering Research Center of Forest Bio-Preparation, Ministry of Education, and Heilongjiang Provincial Key Laboratory of Ecological Utilization of Forestry-based Active Substances, Northeast Forestry University, Harbin150040, China
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Fang J, Huang S, Liu F, He G, Li X, Huang X, Chen HJ, Xie X. Semi-Implantable Bioelectronics. NANO-MICRO LETTERS 2022; 14:125. [PMID: 35633391 PMCID: PMC9148344 DOI: 10.1007/s40820-022-00818-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/09/2022] [Indexed: 06/15/2023]
Abstract
Developing techniques to effectively and real-time monitor and regulate the interior environment of biological objects is significantly important for many biomedical engineering and scientific applications, including drug delivery, electrophysiological recording and regulation of intracellular activities. Semi-implantable bioelectronics is currently a hot spot in biomedical engineering research area, because it not only meets the increasing technical demands for precise detection or regulation of biological activities, but also provides a desirable platform for externally incorporating complex functionalities and electronic integration. Although there is less definition and summary to distinguish it from the well-reviewed non-invasive bioelectronics and fully implantable bioelectronics, semi-implantable bioelectronics have emerged as highly unique technology to boost the development of biochips and smart wearable device. Here, we reviewed the recent progress in this field and raised the concept of "Semi-implantable bioelectronics", summarizing the principle and strategies of semi-implantable device for cell applications and in vivo applications, discussing the typical methodologies to access to intracellular environment or in vivo environment, biosafety aspects and typical applications. This review is meaningful for understanding in-depth the design principles, materials fabrication techniques, device integration processes, cell/tissue penetration methodologies, biosafety aspects, and applications strategies that are essential to the development of future minimally invasive bioelectronics.
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Affiliation(s)
- Jiaru Fang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Shuang Huang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Fanmao Liu
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Gen He
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Xiangling Li
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Xinshuo Huang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Hui-Jiuan Chen
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Xi Xie
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China.
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van der Mierden S, Savelyev SA, IntHout J, de Vries RBM, Leenaars CHC. Intracerebral microdialysis of adenosine and adenosine monophosphate - a systematic review and meta-regression analysis of baseline concentrations. J Neurochem 2018; 147:58-70. [PMID: 30025168 PMCID: PMC6220825 DOI: 10.1111/jnc.14552] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/02/2018] [Accepted: 07/12/2018] [Indexed: 01/18/2023]
Abstract
Microdialysis is a method to study the extracellular space in vivo, based on the principle of diffusion. It can be used to measure various small molecules including the neuroregulator adenosine. Baseline levels of the compounds measured with microdialysis vary over studies. We systematically reviewed the literature to investigate the full range of reported baseline concentrations of adenosine and adenosine monophosphate in microdialysates. We performed a meta‐regression analysis to study the influence of flow rate, probe membrane surface area, species, brain area and anaesthesia versus freely behaving, on the adenosine concentration. Baseline adenosine concentrations in microdialysates ranged from 0.8 to 2100 nM. There was limited evidence on baseline adenosine monophosphate concentrations in microdialysates. Across studies, we found effects of flow rate and anaesthesia versus freely behaving on dialysate adenosine concentrations (p ≤ 0.001), but not of probe membrane surface, species, or brain area (p ≥ 0.14). With increasing flow rate, adenosine concentrations decreased. With anaesthesia, adenosine concentrations increased. The effect of other predictor variables on baseline adenosine concentrations, for example, post‐surgical recovery time, could not be analysed because of a lack of reported data. This study shows that meta‐regression can be used as an alternative to new animal experiments to answer research questions in the field of neurochemistry. However, current levels of reporting of primary studies are insufficient to reach the full potential of this approach; 63 out of 133 studies could not be included in the analysis because of insufficient reporting, and several potentially relevant factors had to be excluded from the analyses. The level of reporting of experimental detail needs to improve. ![]()
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Affiliation(s)
- Stevie van der Mierden
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Sergey A Savelyev
- Medical Biological Research & Development Centre 'Cytomed', St.-Petersburg, Russia
| | - Joanna IntHout
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cathalijn H C Leenaars
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany.,Department of Animals in Science and Society - Human-Animal Relationship, Utrecht University, Utrecht, The Netherlands
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5
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Lee H, Hong YJ, Baik S, Hyeon T, Kim D. Enzyme-Based Glucose Sensor: From Invasive to Wearable Device. Adv Healthc Mater 2018; 7:e1701150. [PMID: 29334198 DOI: 10.1002/adhm.201701150] [Citation(s) in RCA: 294] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/28/2017] [Indexed: 02/07/2023]
Abstract
Blood glucose concentration is a key indicator of patients' health, particularly for symptoms associated with diabetes mellitus. Because of the large number of diabetic patients, many approaches for glucose measurement have been studied to enable continuous and accurate glucose level monitoring. Among them, electrochemical analysis is prominent because it is simple and quantitative. This technology has been incorporated into commercialized and research-level devices from simple test strips to wearable devices and implantable systems. Although directly monitoring blood glucose assures accurate information, the invasive needle-pinching step to collect blood often results in patients (particularly young patients) being reluctant to adopt the process. An implantable glucose sensor may avoid the burden of repeated blood collections, but it is quite invasive and requires periodic replacement of the sensor owing to biofouling and its short lifetime. Therefore, noninvasive methods to estimate blood glucose levels from tears, saliva, interstitial fluid (ISF), and sweat are currently being studied. This review discusses the evolution of enzyme-based electrochemical glucose sensors, including materials, device structures, fabrication processes, and system engineering. Furthermore, invasive and noninvasive blood glucose monitoring methods using various biofluids or blood are described, highlighting the recent progress in the development of enzyme-based glucose sensors and their integrated systems.
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Affiliation(s)
- Hyunjae Lee
- Center for Nanoparticle ResearchInstitute for Basic Science (IBS) Seoul 08826 Republic of Korea
- School of Chemical and Biological EngineeringInstitute of Chemical ProcessesSeoul National University (SNU) Seoul 08826 Republic of Korea
| | - Yongseok Joseph Hong
- Center for Nanoparticle ResearchInstitute for Basic Science (IBS) Seoul 08826 Republic of Korea
- School of Chemical and Biological EngineeringInstitute of Chemical ProcessesSeoul National University (SNU) Seoul 08826 Republic of Korea
| | - Seungmin Baik
- Center for Nanoparticle ResearchInstitute for Basic Science (IBS) Seoul 08826 Republic of Korea
- School of Chemical and Biological EngineeringInstitute of Chemical ProcessesSeoul National University (SNU) Seoul 08826 Republic of Korea
| | - Taeghwan Hyeon
- Center for Nanoparticle ResearchInstitute for Basic Science (IBS) Seoul 08826 Republic of Korea
- School of Chemical and Biological EngineeringInstitute of Chemical ProcessesSeoul National University (SNU) Seoul 08826 Republic of Korea
| | - Dae‐Hyeong Kim
- Center for Nanoparticle ResearchInstitute for Basic Science (IBS) Seoul 08826 Republic of Korea
- School of Chemical and Biological EngineeringInstitute of Chemical ProcessesSeoul National University (SNU) Seoul 08826 Republic of Korea
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Thelin EP, Nelson DW, Ghatan PH, Bellander BM. Microdialysis Monitoring of CSF Parameters in Severe Traumatic Brain Injury Patients: A Novel Approach. Front Neurol 2014; 5:159. [PMID: 25228896 PMCID: PMC4151035 DOI: 10.3389/fneur.2014.00159] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/06/2014] [Indexed: 01/22/2023] Open
Abstract
Background: Neuro-intensive care following traumatic brain injury (TBI) is focused on preventing secondary insults that may lead to irreversible brain damage. Microdialysis (MD) is used to detect deranged cerebral metabolism. The clinical usefulness of the MD is dependent on the regional localization of the MD catheter. The aim of this study was to analyze a new method of continuous cerebrospinal fluid (CSF) monitoring using the MD technique. The method was validated using conventional laboratory analysis of CSF samples. MD-CSF and regional MD-Brain samples were correlated to patient outcome. Materials and Methods: A total of 14 patients suffering from severe TBI were analyzed. They were monitored using (1) a MD catheter (CMA64-iView, n = 7448 MD samples) located in a CSF-pump connected to the ventricular drain and (2) an intraparenchymal MD catheter (CMA70, n = 8358 MD samples). CSF-lactate and CSF-glucose levels were monitored and were compared to MD-CSF samples. MD-CSF and MD-Brain parameters were correlated to favorable (Glasgow Outcome Score extended, GOSe 6–8) and unfavorable (GOSe 1–5) outcome. Results: Levels of glucose and lactate acquired with the CSF-MD technique could be correlated to conventional levels. The median MD recovery using the CMA64 catheter in CSF was 0.98 and 0.97 for glucose and lactate, respectively. Median MD-CSF (CMA 64) lactate (p = 0.0057) and pyruvate (p = 0.0011) levels were significantly lower in the favorable outcome group compared to the unfavorable group. No significant difference in outcome was found using the lactate:pyruvate ratio (LPR), or any of the regional MD-Brain monitoring in our analyzed cohort. Conclusion: This new technique of global MD-CSF monitoring correlates with conventional CSF levels of glucose and lactate, and the MD recovery is higher than previously described. Increase in lactate and pyruvate, without any effect on the LPR, correlates to unfavorable outcome, perhaps related to the presence of erythrocytes in the CSF.
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Affiliation(s)
- Eric P Thelin
- Section for Neurosurgery, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital Solna , Stockholm , Sweden
| | - David W Nelson
- Section of Anesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet , Stockholm , Sweden
| | - Per Hamid Ghatan
- Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden
| | - Bo-Michael Bellander
- Section for Neurosurgery, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital Solna , Stockholm , Sweden
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Wernerman J, Desaive T, Finfer S, Foubert L, Furnary A, Holzinger U, Hovorka R, Joseph J, Kosiborod M, Krinsley J, Mesotten D, Nasraway S, Rooyackers O, Schultz MJ, Van Herpe T, Vigersky RA, Preiser JC. Continuous glucose control in the ICU: report of a 2013 round table meeting. Crit Care 2014; 18:226. [PMID: 25041718 PMCID: PMC4078395 DOI: 10.1186/cc13921] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Achieving adequate glucose control in critically ill patients is a complex but important part of optimal patient management. Until relatively recently, intermittent measurements of blood glucose have been the only means of monitoring blood glucose levels. With growing interest in the possible beneficial effects of continuous over intermittent monitoring and the development of several continuous glucose monitoring (CGM) systems, a round table conference was convened to discuss and, where possible, reach consensus on the various aspects related to glucose monitoring and management using these systems. In this report, we discuss the advantages and limitations of the different types of devices available, the potential advantages of continuous over intermittent testing, the relative importance of trend and point accuracy, the standards necessary for reporting results in clinical trials and for recognition by official bodies, and the changes that may be needed in current glucose management protocols as a result of a move towards increased use of CGM. We close with a list of the research priorities in this field, which will be necessary if CGM is to become a routine part of daily practice in the management of critically ill patients.
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Affiliation(s)
- Jan Wernerman
- Department of Anesthesiology and Intensive Care Medicine, K32, Karolinska University Hospital, Stockholm, Huddinge 14186, Sweden
| | - Thomas Desaive
- GIGA - Cardiovascular Sciences, University of Liege, Institute of Physics, B5, Allee du 6 aout, 17, Liege 4000, Belgium
| | - Simon Finfer
- The George Institute for Global Health and Royal North Shore Hospital, University of Sydney, St Leonards, Sydney, NSW 2065, Australia
| | - Luc Foubert
- Department of Anesthesia and Intensive Care Medicine, OLV Clinic, Aalst 9300, Belgium
| | - Anthony Furnary
- Starr-Wood Cardiac Group, 9155 SW Barnes Road, Portland, OR 97225-6629, USA
| | - Ulrike Holzinger
- Department of Medicine III - Division of Gastroenterology and Hepatology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Roman Hovorka
- University of Cambridge Metabolic Research Laboratories, Level 4, Wellcome trust MRC Institute of Metabolic Science, Box 289, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Jeffrey Joseph
- Jefferson Artificial Pancreas Center and Anesthesiology Program for Translational Research, Department of Anesthesiology, Jefferson Medical College of Thomas Jefferson University, 1020 Walnut Street, Philadelphia, PA 19107, USA
| | - Mikhail Kosiborod
- Saint-Luke’s Mid America Heart Institute, University of Missouri - Kansas City, 4401 Wornall Road, Kansas City, MO 64111, USA
| | - James Krinsley
- Division of Critical Care, Stamford Hospital and Columbia University College of Physicians and Surgeons, 30 Shelburne Road, Stamford, CT 06904, USA
| | - Dieter Mesotten
- Department of Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium
| | - Stanley Nasraway
- Surgical Intensive Care Units, Tufts Medical Center, 800 Washington Street, NEMC 4360, Boston, MA 02111, USA
| | - Olav Rooyackers
- Anesthesiology and Intensive Care Clinic, Karolinska Institute and University Hospital, Huddinge 14186, Sweden
| | - Marcus J Schultz
- Department of Intensive Care Medicine, Academic Medical Center at the University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Tom Van Herpe
- Department of Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium
- Department of Electrical Engineering (STADIUS) - iMinds Future Health Department, Katholieke Universiteit Leuven, Leuven, Heverlee B-3001, Belgium
| | - Robert A Vigersky
- Diabetes Institute, Walter Reed National Military Medical Center, Bethesda, MD 20895, USA
| | - Jean-Charles Preiser
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, 808 route de Lennik, Brussels 1070, Belgium
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Blixt C, Rooyackers O, Isaksson B, Wernerman J. Continuous on-line glucose measurement by microdialysis in a central vein. A pilot study. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2013; 17:R87. [PMID: 23663747 PMCID: PMC3707045 DOI: 10.1186/cc12713] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 05/11/2013] [Indexed: 01/04/2023]
Abstract
Introduction Tight glucose control in the ICU has been proven difficult with an increased risk for hypoglycaemic episodes. Also the variability of glucose may have an impact on morbidity. An accurate and feasible on-line/continuous measurement is therefore desired. In this study a central vein catheter with a microdialysis membrane in combination with an on-line analyzer for continuous monitoring of circulating glucose and lactate by the central route was tested. Methods A total of 10 patients scheduled for major upper abdominal surgery were included in this observational prospective study at a university hospital. The patients received an extra central venous catheter with a microdialysis membrane placed in the right jugular vein. Continuous microdialysis measurement proceeded for 20 hours and on-line values were recorded every minute. Reference arterial plasma glucose and blood lactate samples were collected every hour. Results Mean microdialysis-glucose during measurements was 9.8 ± 2.4mmol/l.No statistical difference in the readings was seen using a single calibration compared to eighth hour calibration (P =0.09; t-test). There was a close agreement between the continuous reading and the reference plasma glucose values with an absolute difference of 0.6+0.8mmol, or 6.8+9.3% and measurements showed high correlation to plasma readings (r = 0.92). Thelimit of agreement was 23.0%(1.94 mmol/l) compared to arterial plasma values with a line of equality close to zero.However, in a Clarke-Error Grid 93.3% of the values are in the A-area,and the remaining part in the B-area.Mean microdialysis-lactate was 1.3 ± 1.1mmol/l. The measurements showed high correlation to the blood readings (r = 0.93). Conclusion Continuous on-line microdialysis glucose measurement in a central vein is a potential useful technique for continuous glucose monitoring in critically ill patients, but more improvements and testingare needed.
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