A new microdialysis probe for continuous lactate measurement during fetal monitoring: Proof of concept in an animal model.

INTRODUCTION: Cardiotocography (CTG) is currently the most commonly used method for intrapartum fetal monitoring during labor. However, a high false-positive rate of fetal acidosis indicated by CTG leads to an increase in obstetric interventions. We developed a microdialysis probe that is integrated into a fetal scalp electrode allowing continuous measurement of lactate subcutaneously, thus giving instant information about the oxygenation status of the fetus. Our aim was to establish proof of concept in an animal model using a microdialysis probe to monitor lactate subcutaneously. MATERIAL AND METHODS: We performed an in vivo study in adult male wild-type Wistar rats. We modified electrodes used for CTG monitoring in human fetuses to incorporate a microdialysis membrane. Optimum flow rates for microdialysis were determined in vitro. For the in vivo experiment, a microdialysis probe was inserted into the skin on the back of the animal. De-oxygenation and acidosis were induced by lowering the inspiratory oxygen pressure. Oxygenation and heart rate were monitored. A jugular vein cannula was inserted to draw blood samples for analysis of lactate, pH, pco2 , and saturation. Lactate levels in dialysate were compared with plasma lactate levels. RESULTS: Baseline blood lactate levels were around 1 mmol/L. Upon de-oxygenation, oxygen saturation fell to below 40% for 1 h and blood lactate levels increased 2.5-fold. Correlation of dialysate lactate levels with plasma lactate levels was 0.89 resulting in an R2 of .78 in the corresponding linear regression. CONCLUSIONS: In this animal model, lactate levels in subcutaneous fluid collected by microdialysis closely reflected blood lactate levels upon transient de-oxygenation, indicating that our device is suitable for subcutaneous measurement of lactate. Microdialysis probe technology allows the measurement of multiple compounds in the dialysate, such as glucose, albumin, or inflammatory mediators, so this technique may offer the unique possibility to shed light on fetal physiology during the intrapartum period.

Microfiltration sampling in rats and in cows: toward a portable device for continuous glucocorticoid hormone sampling.

To monitor temporal patterns of glucocorticoids hormones in living animals, most often blood samples are collected. Blood sampling is invasive and subjects may find it--in particular--unpleasant when multiple samples are collected. We have developed a microfiltration collection device (MCD) sampling continuously, pulse-free, over a selected period of time, with minimum invasiveness as the device is inserted with only one venipuncture. The MCD consists of a hollow fiber membrane (probe), capillary collection coil and flow creator. Three biocompatible hollow fiber membranes were assessed on flow rate in rats, by placing the probe intraperitoneally, subcutaneously, or intravascularly and with or without heparin coating. The probe made from polyethylene coated with ethylene vinyl alcohol-heparin conveyed the best results and had the most benefit of the heparin coating. Consequently this probe was built into a collection device and tested in cows, sampling blood microfiltrate. Cortisol (protein-bound and -free) could be monitored in cows over a period of 7 hours. This device has several major advantages compared to manual blood collection: minor stress is induced by the application of the device; it has a low weight and can therefore be used in freely active subjects being in their own surroundings. The device can be sterilized and manufactured as a disposable tool, and the filled MCD can be shipped by regular mail to a specialized laboratory facility for analysis.

Ultraslow microdialysis and microfiltration for in-line, on-line and off-line monitoring.

In medicine and biotechnology, close monitoring of molecular processes might assist to optimise therapeutic interventions and production of biochemicals, respectively. Here, we summarize the current status of two automatic and continuous sampling technologies, microdialysis and microfiltration, which facilitate both in vivo and in vitro monitoring of nearly any analyte, because they can be combined easily with many analytical techniques. Conventional microdialysis and microfiltration, which require collecting relatively large samples, are however often impractical and semi-quantitative; hence, we focus on ultraslow sampling to circumvent such limitations. Ultraslow microdialysis and microfiltration already have been used successfully for quantitative pharmacokinetics, glucose metabolism (e.g. of the brain), cytokines and proteomics (e.g. tumour secretomes), both in vivo and in vitro.

Quantitative microdialysis using modified ultraslow microdialysis: direct rapid and reliable determination of free brain concentrations with the MetaQuant technique.

The only method to quantify free extracellular levels of drugs in the brain of living animals is microdialysis. However, quantitative microdialysis has been hampered by methodological issues for decades. The problems arise from the need to establish the in vivo recovery for appropriate quantitation. In dealing with these issues the "dynamic no-net-flux" (DNNF) method seemed to be the experimental method of choice. Major disadvantages were, however, the need for a very high degree of bioanalytical precision and accuracy and the need for a large number of animals. Moreover, today we know that the experimental data are not always straightforward. To improve robustness and practicality of quantitative microdialysis sampling we modified the ultraslow microdialysis approach. Ultraslow microdialysis uses very low microdialysis flow rates (<200 nl/min) which increase recovery (both in vivo and in vitro) to over 90%. However, new practical issues arise when attempting to work with these flow rates. The resulting very low volumes and long lag times make this method very impractical for general application. In the modified version, addition of a carrier flow after the dialysis process has been completed, which negates the problems of long lag times and low volumes. The resulting dilution of the dialysis sample concentration can simply be mathematically corrected. In the current study we measured the free brain levels of two CNS compounds using the classic DNNF and the new modified ultraslow dialysis method. Modified ultraslow microdialysis was shown to generate robust data with the use of only small numbers of rats. The method is a promising tool for common straightforward screening of blood-brain barrier penetration of compounds into the brain.

In vitro sampling and storage of proteins with an ultrafiltration collection device (UCD) and analysis with absorbance spectrometry and SELDI-TOF-MS.

Frequent in vivo sampling of blood proteins is often stressful, making it difficult to obtain more than a few samples. As a result, only limited time-profiles can be made. We have developed an ultrafiltration collection device (UCD) for continuous sampling. The UCD consists of a hollow fiber, a coil and a flow creator. Hollow fiber membranes are often hydrophobic and this can result in adsorption of protein and/or peptides, leading to clogged membranes. Adsorption was tested with a hydrophobic and hydrophilic peptide and two biocompatible hollow fibers made from different materials. The hollow fiber made from poly(ethylene) coated with ethylenevinyl alcohol gave near 100% recovery for both peptides. This was in contrast to the poly(sulfone) hollow fiber when sampling the hydrophobic peptide. Filling the coil with various peptide concentrations gave good recovery and insignificant diffusion even after storage for 6 d at 37 degrees C. Continuous pulse-free sampling was tested by vacuum. An average flow rate of 423 +/- 50 nl min(-1) over a period of 4 d was created using S-Monovette. The flow rate gradually declined during this period by <5% every consecutive day. In addition, we also examined a complex sample-serum in the poly(ethylene) hollow fiber. Serum and ultrafiltrate were spotted onto a protein chip and analyzed by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS). Six proteins out of 64 were found to be significantly different between serum and the ultrafiltrate (p < 0.05). The UCD has the potential to be used for in vivo real-time monitoring.