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Updated: Apr 15, 2026
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Real-Time Dynamic Collection of Hippocampal Extracellular Fluid from Conscious Rats Using a Microdialysis System
Published on: October 21, 2022
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Consensus statement from the 2025 Delphi panel on cerebral microdialysis in critical care.
Adel Helmy1, Michael S Baker2, Patrick M Chen3
1Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Critical Care (London, England)
|April 14, 2026
Summary
Updated guidelines for cerebral microdialysis (CMD) in critical care were established through expert consensus. This consensus provides standardized practice recommendations for optimizing treatment and improving outcomes in neurocritical care patients.
Area of Science:
- Neurocritical Care
- Intensive Care Medicine
- Cerebral Metabolism Monitoring
Background:
- Secondary brain injury significantly impacts outcomes after neurological trauma.
- Optimizing treatment necessitates real-time monitoring of cerebral metabolism.
- Cerebral microdialysis (CMD) offers unique insights into brain metabolism, but consensus on its use is outdated.
Purpose of the Study:
- To assess expert consensus on the application of CMD in critical care settings.
- To provide contemporary guidance for standardizing CMD practice.
- To facilitate the advancement of clinical implementation of CMD.
Main Methods:
- A 3-round modified Delphi study was employed.
- International experts in CMD and neurocritical care participated.
- Consensus required ≥75% agreement among at least 30 non-abstaining respondents.
Main Results:
- Sixty of 62 items (97%) achieved consensus across 9 domains.
- Consensus covered indications, technical aspects, interpretation, and treatment algorithms.
- Key areas included glucose management, reporting standards, and implementation barriers.
Conclusions:
- Updated, evidence-informed recommendations for CMD in critical care are presented.
- Core recommendations from 2014 were reaffirmed with advancements.
- Guidance was extended to intracerebral hemorrhage, and comprehensive reporting items were defined.
