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Consensus statement from the 2025 Delphi panel on cerebral microdialysis in critical care

Helmy, Adel ; Baker, Michael S. ; Chen, Patrick M. ; Quinn, Aoife ; Jalloh, Ibrahim ; Roberts, Louise ; Badjatia, Neeraj ; Belli, Antonio ; Boutelle, Martyn G. and Bullock, M. Ross , et al. (2026) In Critical Care 30(1).
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute brain injury, Cerebral microdialysis, Consensus, Delphi technique, Intracerebral hemorrhage, Multimodal monitoring, Neurocritical care, Neuromonitoring, Subarachnoid hemorrhage, Traumatic brain injury
in
Critical Care
volume
30
issue
1
article number
262
publisher
BioMed Central (BMC)
external identifiers
  • scopus:105039565510
  • pmid:41975464
ISSN
1364-8535
DOI
10.1186/s13054-026-05993-z
language
English
LU publication?
yes
id
5d56be0e-8549-40b9-b49a-497d02bc25ce
date added to LUP
2026-08-24 15:05:21
date last changed
2026-08-25 03:00:04
@article{5d56be0e-8549-40b9-b49a-497d02bc25ce,
  abstract     = {{<p>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.</p>}},
  author       = {{Helmy, Adel and Baker, Michael S. and Chen, Patrick M. and Quinn, Aoife and Jalloh, Ibrahim and Roberts, Louise and Badjatia, Neeraj and Belli, Antonio and Boutelle, Martyn G. and Bullock, M. Ross and Claassen, Jan and Coles, J. P. and Dahyot-Fizelier, Claire and Ercole, Ari and Foreman, Brandon and Gallagher, Clare and Gilmore, Emily J. and Gupta, Arun K. and Gupta, Deepak and Helbok, Raimund and Leroux, Peter and Magnoni, Sandra and Mangat, Halinder S. and Marklund, Niklas and Mazzeo, Anna Teresa and Menon, David K. and Nelson, David W. and Newcombe, Virginia and Oddo, Mauro and O’Phelan, Kristine and Petrone, Patrizio and Poca, Maria A. and Puccio, Ava M. and Robertson, Claudia S. and Rostami, Elham and Sahuquillo, Juan and Stovell, Matthew G. and Strong, Anthony J. and Svedung Wettervik, Teodor and Thelin, Eric P. and Timofeev, Ivan S. and Torné, Ramon and Valadka, Alex and Venturini, Sara and Vespa, Paul and Zimphango, Chisomo and Carpenter, Keri L.H. and Chen, Jefferson W. and Hutchinson, Peter J.}},
  issn         = {{1364-8535}},
  keywords     = {{Acute brain injury; Cerebral microdialysis; Consensus; Delphi technique; Intracerebral hemorrhage; Multimodal monitoring; Neurocritical care; Neuromonitoring; Subarachnoid hemorrhage; Traumatic brain injury}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Critical Care}},
  title        = {{Consensus statement from the 2025 Delphi panel on cerebral microdialysis in critical care}},
  url          = {{http://dx.doi.org/10.1186/s13054-026-05993-z}},
  doi          = {{10.1186/s13054-026-05993-z}},
  volume       = {{30}},
  year         = {{2026}},
}