Cerebral microdialysis

Cerebral microdialysis is one of the latest neuromonitoring modalities introduced to clinical practice. It is a bedside monitor used to assess brain tissue biochemistry. The principle of this technique is closely related to brain metabolism and dialysis. Microdialysis helps monitoring different metabolites related to energy and metabolic cascades (glucose, lactate and pyruvate), amino acids (glutamate) and markers of cell membrane degradation (glycerol). Its role has been established in conditions such as traumatic brain injury, subarachnoid haemorrhage, ischaemic stroke, etc. However, it is yet to be included in routine neuromonitoring as the technique is very expensive, needs technical expertise and the measurement is not continuous with a lag period in-between two readings. Till date, it is mostly used as a research tool, even though it is a very promising technique in certain clinical conditions

Bougie through Murphy’s Eye During Airway Exchange: A Near Miss

Endotracheal tube (ETT) exchange is a common procedure performed in the operating room and intensive care unit for the purpose of changing damaged or soiled ETT with appropriate one. The exchange procedure is performed over an airway exchange catheter or ETT introducer (bougie). We report an event during ETT exchange over bougie wherein the introducer exited through Murphy’s eye. Here, we intend to re-emphasize the safety concerns pertaining to the use of bougie (with coude tip) as airway exchange conduit and enumerate the precautions to be taken during tube exchange