Evidence map›Paper›PMID 41975464›Full record

ReviewCritical care (London, England)2026

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

Adel Helmy, Michael S Baker, Patrick M Chen, Aoife Quinn, Ibrahim Jalloh, Louise Roberts, Neeraj Badjatia, Antonio Belli, Martyn G Boutelle, M Ross Bullock and 39 more

Abstract readConsensus StatementReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The microdialysis-derived lactate-pyruvate gradient indicates anaerobic activity after brain injury.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

49 authors.

Adel Helmy *Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-0531-0556
Michael S Baker *Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK. msb74@cam.ac.uk.ORCID http://orcid.org/0009-0006-3078-3001
Patrick M ChenNeurology Traumatic Brain Injury & Concussion (NTBIC) Program, Department of Neurology, University of California, Irvine, Irvine, CA, USA.ORCID http://orcid.org/0000-0003-4505-964X
Aoife QuinnNeurosciences Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Ibrahim JallohDepartment of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID http://orcid.org/0000-0002-5345-5928
Louise RobertsNeurosciences Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Neeraj BadjatiaDivision of Neurocritical Care & Emergency Neurology, Department of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, USA.ORCID http://orcid.org/0000-0003-1509-9034
Antonio BelliNIHR Health Protection Research Unit for Emergency Preparedness and Response, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0002-3211-9933
Martyn G BoutelleDepartment of Bioengineering, Imperial College London, London, UK.ORCID http://orcid.org/0000-0003-1332-3442
M Ross BullockDepartment of Neurological Surgery, University of Miami, Miami, FL, USA.
Jan ClaassenDivision of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Irving Medical Center, New York- Presbyterian Hospital, New York, NY, USA.ORCID http://orcid.org/0000-0002-5893-8531
J P ColesPerioperative, Acute, Critical, and Emergency Care (PACE) Section, Department of Medicine, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0003-4013-679X
Claire Dahyot-FizelierUniversité de Poitiers, Inserm U1070, PHAR2, Poitiers, France.ORCID http://orcid.org/0000-0002-3933-0619
Ari ErcoleDepartment of Medicine, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0001-8350-8093
Brandon ForemanDepartment of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA.ORCID http://orcid.org/0000-0002-5418-674X
Clare GallagherSection of Neurosurgery, University of Calgary, Calgary, AB, Canada.
Emily J GilmoreNeurocritical Care and Emergency Neurology, Departments of Neurology and Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.ORCID http://orcid.org/0000-0002-4659-6861
Arun K GuptaNeurosciences Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Deepak GuptaDepartment of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.ORCID http://orcid.org/0000-0001-7698-5668
Raimund HelbokDepartment of Neurology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria.ORCID http://orcid.org/0000-0001-5682-0145
Peter LerouxBassett Healthcare Network, Cooperstown, NY, USA.
Sandra MagnoniAnesthesiology and Pain Medicine Service, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.ORCID http://orcid.org/0000-0002-1723-0844
Halinder S MangatDepartment of Neurology, Division of Neurocritical Care, University of Kansas Medical Center, Kansas City, KS, USA.ORCID http://orcid.org/0000-0003-3426-2001
Niklas MarklundDepartment of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.ORCID http://orcid.org/0000-0002-9797-5626
Anna Teresa MazzeoDepartment of Human Pathology of Adult and Evolutive Age, Division of Anesthesia and Intensive Care, AOU "G. Martino", University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0002-8454-7243
David K MenonDepartment of Medicine, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-3228-9692
David W NelsonDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.ORCID http://orcid.org/0000-0003-2530-8207
Virginia NewcombePerioperative, Acute, Critical, and Emergency Care (PACE) Section, Department of Medicine, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0001-6044-9035
Mauro OddoInnovation and Clinical Research, CHUV-Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Kristine O'PhelanNeurocritical Care, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
Patrizio PetroneNYU Grossman Long Island School of Medicine, Mineola, NY, USA.ORCID http://orcid.org/0000-0002-7629-1663
Maria A PocaDepartment of Neurosurgery, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID http://orcid.org/0000-0002-3831-0536
Ava M PuccioDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.ORCID http://orcid.org/0000-0003-2569-9607
Claudia S RobertsonDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, USA.ORCID http://orcid.org/0000-0002-8509-678X
Elham RostamiSection of Neurosurgery, Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.ORCID http://orcid.org/0000-0003-1218-6247
Juan SahuquilloDepartment of Neurosurgery, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID http://orcid.org/0000-0003-0713-5875
Matthew G StovellNeurosurgery Service, The Walton Centre, Liverpool, UK.ORCID http://orcid.org/0000-0002-4172-4617
Anthony J StrongDepartment of Basic and Clinical Sciences, School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID http://orcid.org/0000-0003-2432-5945
Teodor Svedung WettervikDepartment of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.ORCID http://orcid.org/0000-0002-4556-5721
Eric P ThelinDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-2338-4364
Ivan S TimofeevDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-1168-0393
Ramon TornéDepartment of Neurosurgery, Hospital Clinic de Barcelona, Barcelona, Spain.ORCID http://orcid.org/0000-0001-7932-2528
Alex ValadkaDepartment of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID http://orcid.org/0000-0003-0156-1531
Sara VenturiniDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-9541-0090
Paul VespaDavid Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, USA.ORCID http://orcid.org/0000-0003-0936-9501
Chisomo ZimphangoDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-3147-1150
Keri L H CarpenterDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0001-8236-7727
Jefferson W ChenDepartment of Neurological Surgery, University of California, Irvine, Irvine, CA, USA.ORCID http://orcid.org/0000-0003-0624-6864
Peter J HutchinsonDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-2796-1835

Funding

Medical Research Council MR/X021882/1Medical Research Council/Royal College of Surgeons of England G0802251
6 · The paper itself

Abstract

purposeSecondary 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.

methodsWe 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.

resultsForty 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.

conclusionThis 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.

Indexed as

Critical CareMicrodialysisBrain InjuriesDelphi TechniqueHumansAcute brain injuryCerebral microdialysisConsensusDelphi techniqueIntracerebral hemorrhageMultimodal monitoringNeurocritical careNeuromonitoringSubarachnoid hemorrhageTraumatic brain injury

Identifiers

PMID41975464
PMCPMC13185327

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.