Metabolisches Monitoring im perioperativen und intensivmedizinischen Kontext

The microdialysis technique is now a feasible technique for measuring drug concentrations, markers of cell injury and metabolites in the interstitial fluid of nearly every organ. Animal and human studies have been used to monitor the different steps in the development of acute ischemic injury on a cellular level. Interstitial fluid component changes reflect intracellular disorder. In more than 10000 papers on microdialysis research it has been used to uncover physiological mechanisms and the influence of drugs in almost every organ of the body. Since the first papers were published describing microdialysis in the human brain, it has become a technique for routine monitoring of energy metabolism especially in neurointensive care. This paper gives an account of the microdialysis technique describing its practical use and interpretation in monitoring energy metabolism and ischemia in different organs with respect to the field of perioperative and intensive care medicine. This article gives an overview on current results of clinical studies using microdialysis in critical care medicine and tries to focus on possible indications for clinical biochemical monitoring. However, despite numerous publications available, microdialysis has not been shown to improve outcome of the patients yet.