Let me tell you, folks, when it comes to traumatic brain injuries (TBI), we’ve got something incredible called cerebral microdialysis (CMD). It’s fantastic, really. It measures things like the lactate to pyruvate ratio, the LP ratio, to optimize brain perfusion. It’s all about making sure the brain gets what it needs, believe me.

We had this goal, okay? We wanted to spot cerebral ischemia in TBI patients who needed a decompressive craniectomy. And not just that, we looked at how this all ties together with cerebral perfusion pressure (CPP) and intracranial pressure (ICP). And let me tell you, we also wanted to see if boosting CPP could help with these ischemia biomarkers. It’s all about getting results.

After getting the green light from the Ethics Committee, we got seven adults on board. These folks needed surgery after a TBI, and we tracked their CMD data for 72 hours. If their LP ratio went over 40, we cranked up their CPP by 20% using noradrenaline. We checked everything, used bootstrapping because we’re thorough, but guess what?

Out of our group, one had cerebral ischemia, and another had something else going on, not ischemia but mitochondrial dysfunction. And when we looked at the numbers, the LP ratio, CPP, ICP, they weren’t talking to each other. No correlation. And even when we boosted CPP, the brain chemistry, it didn’t budge. Not what we expected.

So, here’s the deal: CMD can spot ischemia, but boosting CPP? It didn’t do the trick. We’ve got to dive deeper, do more research to really get to the bottom of brain metabolism in TBI. It’s crucial, and we’re just getting started.