Consensus statement from the 2025 Delphi panel on cerebral microdialysis in critical care
Year: 2026
Type: supplementary-materials
Abstract: Purpose Secondary brain injury is a common cause of poor outcome after trauma, subarachnoid hemorrhage, and intracerebral hemorrhage, and optimizing treatment requires real-time insight into cerebral metabolism. Cerebral microdialysis (CMD) uniquely provides key related information, yet consensus on its use has not been updated since publication of the consensus statement from the 2014 International Microdialysis Forum. We aimed to assess expert consensus on the use of CMD in critical care and provide contemporary guidance to standardize practice and advance clinical implementation. Methods We conducted a 3-round modified Delphi study with international experts in CMD and neurocritical care. Consensus was defined as ≥ 75% agreement among non-abstaining respondents, with a minimum of 30 non-abstaining respondents required per statement. Statements not reaching consensus were iteratively revised based on panelist feedback. Results Forty of 67 invited experts (60%) from 9 countries participated. Sixty of 62 individual items achieved consensus (97%) across 9 domains: indications and patient selection, technical and procedural considerations, detecting deterioration and secondary injury, metabolic interpretation, treatment algorithms, glucose management, sampling frequency, core reporting items, and barriers to clinical implementation. Conclusion This consensus statement provides updated, evidence-informed recommendations for the use of CMD in critical care. The panel reaffirmed many core recommendations from the 2014 consensus while making targeted advances: cautious extension of guidance to intracerebral hemorrhage, comprehensive reporting guidance addressing frequently omitted elements (19 items vs. 6 in 2014), and identification of 10 key barriers to routine clinical adoption.
Source: Figshare
Authors: Helmy, Adel, Baker, Michael S., Chen, Patrick M., Quinn, Aoife, Jalloh, Ibrahim, Roberts, Louise, Badjatia, Neeraj, Belli, Antonio, Boutelle, Martyn G., Bullock, M. Ross, Claassen, Jan, Coles, J. P., Dahyot-Fizelier, Claire, Ercole, Ari, Foreman, Brandon, Gallagher, Clare, Gilmore, Emily J., Gupta, Arun K., Gupta, Deepak, Helbok, Raimund, Leroux, Peter, Magnoni, Sandra, Mangat, Halinder S., Marklund, Niklas, Mazzeo, Anna Teresa, Menon, David K., Nelson, David W., Newcombe, Virginia, Oddo, Mauro, O’Phelan, Kristine, Petrone, Patrizio, Poca, Maria A., Puccio, Ava M., Robertson, Claudia S., Rostami, Elham, Sahuquillo, Juan, Stovell, Matthew G., Strong, Anthony J., Svedung Wettervik, Teodor, Thelin, Eric P., Timofeev, Ivan S., Torné, Ramon, Valadka, Alex, Venturini, Sara, Vespa, Paul, Zimphango, Chisomo, Carpenter, Keri L. H., Chen, Jefferson W., Hutchinson, Peter J.
Institutions: University of Cambridge, University of California, Irvine, Cambridge University Hospitals NHS Foundation Trust, University of Maryland, Baltimore, University of Birmingham, Imperial College London, University of Miami, Columbia University Irving Medical Center, Centre Hospitalier Universitaire de Poitiers, University of Cincinnati, University of Calgary, Yale University, All India Institute of Medical Sciences, Johannes Kepler University of Linz, Bassett Healthcare Network, University of Sassari, University of Kansas Medical Center, Lund University, Skåne University Hospital, University of Messina, Karolinska University Hospital, Karolinska Institutet, University of Lausanne, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, University of Pittsburgh, Baylor College of Medicine, Uppsala University Hospital, Walton Centre, King's College London, Uppsala University, Hospital Clínic de Barcelona, The University of Texas Southwestern Medical Center, University of California, Los Angeles
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7161696581