NSICU Using Cutting-Edge Technique in Patient Care

Jackson Memorial Hospital in Miami is the only hospital the southeastern United States using clinical microdialysis in its neuroscience intensive care unit and patients suffering from subarachnoid hemorrhage (stroke) and traumatic brain injuries are already benefiting from the technique. The NSICU nursing team is excited to have this cutting-edge neuromonitoring available in its spectrum for nursing care.

Microdialysis is used to measure cerebral metabolism and allows neuroscience clinicians the ability to identify changes in brain chemistry before clinical symptoms are present. Identifying such problems in advance gives caregivers an opportunity for earlier intervention and prevention of secondary brain injury. The data retrieved from the monitoring is used to evaluate treatment measures and make clinical decisions.

The first patient treated with microdialysis at Jackson suffered a traumatic brain injury that resulted in a coma. M. Ross Bullock, M.D., Ph.D., director of clinical neurotrauma at Jackson’s Ryder Trauma Center and professor of neurological surgery at the University of Miami Miller School of Medicine, managed the care of the patient and inserted the microdialysis catheter. NSICU clinical nurse educator, Lee Fong-Hong, R.N., M.S.N., M.B.A., and Jillian Miller, R.N., B.S.N., also played a crucial role in the patient’s care and the usage of the microdialysis device by running analysis on samples, interpreting data and recording the results. The knowledge and skills required to provide nursing care for patients with microdialysis demands a 1:1 nurse patient ratio.

(l-r) Lee Fong-Hong, R.N., M.S.N., M.B.A., neuroscience intensive care unit clinical nurse educator at Jackson Memorial Hospital; Dr. Urban Ungerstedt, the inventor of the CMA600 microdialysis neuromonitoring system; and Dr. M. Ross Bullock, director of clinical neurotrauma at Jackson’s Ryder Trauma Center and professor of neurological surgery at the University of Miami Miller School of Medicine.

Nurses and the neuro critical care team in Jackson’s NSICU were recently visited by Urban Ungerstedt, Ph.D., the inventor of the CMA600 Microdialysis neuromonitoring system. Ungerstedt, a professor at Karolinska Institute in Stockholm, Sweden, toured the unit and spent time with the staff, discussing how Jackson is using microdialysis to improve patient outcomes. The staff was able to engage in an informative discussion with Dr. Ungerstedt about the clinical implications of data trends in patients treated with microdialysis.

The neuroscience nurses in Jackson’s NSICU have now added this experience to their neuroscience specialty practice and expertise. Fong-Hong, the NSICU clinical nurse educator at Jackson, is optimistic this new technique will be an invaluable tool in patient care.

“We look forward to the future of utilizing the data trends to make clinical decisions leading to improved patient outcomes,” Fong-Hong said.

In addition to Jackson, three other hospitals in the United States are using microdialysis in a clinical setting. They are: New York Presbyterian Hospital, Duke University Hospital and Legacy Health in Portland, OR.