Title:Microdialysis-Assessed Adipose Tissue Metabolism in Critically Ill Patients
Volume: 11
Issue: 1
Author(s): Ioannis Ilias*, Nikitas Nikitas, Maria Theodorakopoulou and Ioanna Dimopoulou
Affiliation:
- Endocrinology Unit, Elena Venizelou Hospital, Athens,Greece
Keywords:
Adipose tissue, intensive care units, lipolysis, subcutaneous fat, microneedle arrays, metabolism, microdialysis.
Abstract: Background: Microdialysis is a minimally invasive technique that allows direct in situ and in
vivo sampling, studies and manipulations of the interstitial/extracellular fluid/space. It has been shown
to be of use mainly in acute brain injury/neurocritical care.
Methods: Microdialysis has been used to study obesity, diabetes mellitus, inflammation and pharmacokinetics
at the adipose tissue level. In critically ill patients (and particularly in those with sepsis or septic
shock), within days to weeks, adipose tissue shows profound alterations; under such conditions, the
implementation of microdialysis can provide researchers with interesting findings.
Results: The well-known association between lipolysis and cortisol has been verified at the tissue level
with microdialysis. Specific metabolic aberrations in critically ill patients with septic shock have been
noted in adipose tissue - assessed with microdialysis before becoming evident in the systemic circulation.
Measurement of the lactate to pyruvate ratio in adipose tissue - also assessed with microdialysis -
in patients with septic shock has prognostic value equal to that of universally accepted clinical severity
scores.
Conclusion: Microneedle arrays have been already used to assess interstitial fluid glucose. Possibly, the
implementation of microneedle and lab-on-a-chip technology, might complement the current use of
microdialysis in the study of the interstitial space/adipose tissue metabolism in health and disease.
