BGS Global Hospitals Equipped With Microdialysis Facility For The Brain - First In Asia

Online, December 11, 2010 (Newswire.com) - Advanced Neurosciences Institute at BGS Global Hospitals, Bangalore, India, a part of the Global Hospitals Group is now equipped with Asia's first microdialysis facility for the brain adding to its existing world class technology and infrastructure.

Dr. N. K. Venkataramana, Chief Neurosurgeon and Vice-Chairman, BGS Global Hospitals said, "We are the first hospital in Asia and among 20 hospitals in world to be equipped with this facility. Microdialysis helps to predict outcome in the case of brain haemorrhage, brain injury and strokes. It is a unique equipment to identify chemical changes that may develop into secondary damage before it manifests as clinical signs thus providing an opportunity for clinicians to identify and predict the extent of damage at least 24 hours in advance before any permanent damage can happen. We can understand what is happening inside in the brain and is a real boon at that crucial time."

He added, "It gives us an opportunity of a therapeutic window to intervene early to take measures to prevent a permanent damage. It also provides a real time feedback of any therapeutic intervention so that it allows the clinician to modify and choose the best therapy for the specific patient. It is also helpful in monitoring brain changes in some of the malignant brain tumour cases."

This exciting new microdialysis facility was set up with the help of Karolinska Intitutet of Sweden by a reputed team including Dr. Christos Panotopoulos, Visiting Consultant Neurosurgeon, BGS Global Hospitals and Dr Magnus Hedberg, Chief Clinical Engineer of CMA Microdialyis. The microdialysis facility is an essential feature of the hospital's neurocritical care unit making it a fullfledged centre for treatment as well as for future research and training of other centres in the Asian Continent.

Key Patient benefits
This facility has changed the guidelines of treatment of brain injury as it offers immense benefits to the patient.
• Helps the clinician to identify the extent of damage to the brain that can occur 24 hours in advance
• Early treatment helps minimize secondary damage to the brain
• Better results in treatment
• It is helpful in cutting short the period of intensive care
• It helps reduce complications
• Helps in cutting down unnecessary medications
• Useful when patient cannot communicate about his condition
• Reduces overall hospital stay

Microdialysis - Introduction

Brain is the most sensitive organ in the body. Brain injury, stroke, haemorrhage or surgery can lead to a number of metabolic as well as structural changes in the brain.

The secondary damage like loss of blood supply, glucose supply, oxygen supply, can lead to metabolic disturbances resulting in disturbances in the brain cell function. This dysfunction can result in either metabolic failure or an electrical failure leading to functional disability. Neurocritical care has evolved over the years where neurosurgeons are trying to monitor various functions of the brain. Thus EEG evoked potentials, ICP monitoring, cerebral blood flow monitoring, cerebral oxygen utilization monitoring were done in the past to promote good functional recovery. Despite all this and imaging technologies like MRI, it is very difficult to monitor the ongoing cellular function and viability.

Microdialysis - How does it work?

Dr. Venkataramana added, "Microdialysis is a technology for continuous sampling of the interstitial fluid from the brain which will helps us analyse the molecular substance resulting from the metabolic activity. Interstitial fluid is the crossroad of all the substances passing between the blood capillaries and the brain cells. By monitoring this compartment we will get crucial information about the biochemistry of the neurons and the glia."

This is achieved by introduction of a fine sophisticated catheter in the brain substance at the area of interest which acts as a "biosensor". The samples of the tissue chemistry are continuously analysed for lactate, pyruvate, glycerol, glucose and glutamate. This will indicate the ischemia, hyperemia, oedema, vasospasm and various physiological changes that can happen in the brain.

The future of neurosurgery

Dr. Christos Panotopoulos, Visiting Consultant Neurosurgeon, BGS Global Hospitals, said, "A new era of neurosurgery called molecular neurosurgery is evolving. In the future this technology will also allow us to analyse the neurotransmitters, energy metabolites, cytokines and small proteins and the drug level in order to promote research to the next higher level of understanding of brain disease pathways with the introduction of microdialysis."