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ISSN 2448-8909 (Print)

2001, Number 6

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Med Crit 2001; 15 (6)

Brain tissue oxygen monitoring: A tool for prevention and treatmentof traumatic cerebral ischemia

Carmona SJA, Van den Brink W, Van Santbrink H, Hogesteeger C, Steyerberg PE, Sosa EL, Mass A

Language: Spanish
References: 189
Page: 185-202
PDF size: 244.85 Kb.


ABSTRACT

Objective: To present our experience on the brain tissue oxygen monitoring to promote this technique in Mexico for the attention of severe head trauma. Design: Prospective study between 1992 to 1996. Setting: ICU of an Universitary Hospital, Rotterdam. The Netherlands. Patients: A total of 101 patients (mean age 35 ± 17 years, range 11-83 years) were enrolled. Interventions: With the purpose to prevent, detect and treat the cerebral ischemia, brain tissue oxygen monitoring was made through a catheter implanted in the encephalic white matter. Measurements and main results: Intracranial pressure (ICP), partial pressure of brain tissue oxygen (PtO²c), arterial CO² pressure (PaCO²), the basal-final difference of ICP (DICP), PtO²c (DPtO²c) and PaCO² (DPaCO²)., cerebral perfusion pressure, Glasgow coma score and Glasgow outcome score (GOS) were registered. Outcome was related with ICP and PtO²c/PaCO² and ICP and PtO²c/PaCO² (p ‹ 0.5). Conclusion: This procedure is a useful tool for the monitoring of critically ill patient with severe head trauma.


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  125. Doppenberg EMR, Zauner A, Bullock R et al. Determination of the ischemic threshold for the brain tissue oxygenation in the severely head injured patient. X intracranial pressure and neuromonitoring in brain injury, Williamsburg USA 1997;PO-2-056.

  126. Dings J, Meixensberger J, Amschler J, Hamelbeck B et al. Brain tissue PO2 in relation to cerebral perfusion pressure, TCD findings and TCD reactivity after severe head injury. Acta Neurochir 1996;138:425-434.

  127. Valadka AB, Gopinath SP, Contant CF, Usura M, Robertson CS. Relationship of brain tissue PO2 to outcome after severe head injury. Critical Care Med 1998;26:1576-1581.

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  133. Maas AIR, Dearden M, Teasdale GM, Braakman R, Cohadon F, Iannotti F, Karimi A, Lapierre F, Murray G, Ohman J. European Brain Injury Consortium (EBIC)- Guidelines for management of severe head injury in adults. Acta Neurochir (Wien) 1997;139:286-294.

  134. Jennettt B, Bond M. Assessment of outcome after severe brain damage. A practical scale. The Lancet 1975:480-484.

  135. Harrel FE. Desing: S-plus functions for biostatical/epidemiological modelling, testing, estimation, validations, graphics, prediction and type setting by storing enhanced model design atributes in the fit. Programs viable at Internet: http://lib.stat.cmu.edu. Accessed 1977.

  136. Marshall LF, Marshall SB, Klauber MR et al. A new classification of head injury based on computarized tomography. J Neurosurg 1991;75:S14-S20.

  137. Dings J, Meixensberg J, Roosen K. Brain tissue PO2-monitoring: catheterstability and complications. Neurological Res 1997:19:1-5.

  138. Kiening KL, Untenberg AW, Bardt TF, Schenider GH, Lanksch WR. Monitoring of cerebral oxygenation in patients with severe head injuries: brain tissue PO2 versus jugular vein oxygen saturation. J Neurosurg 1996;85:751-757.

  139. Dearden NM, Midgley S. Technical considerations in continuous jugular venous oxygen saturation in the management of severe head injury. Curr Opin Anaesth 1991;4:279-286.

  140. Dearden NM. Jugular bulb venous oxygen saturation in the management of severe head injury. Acta Neurochir (Suppl) 1993;59:91-97.

  141. Fortune JB, Feustel PI, Weigle CGM et al. Continuous measurement of jugular venous oxygen saturation in response to transient elevations of blood pressure in head-injured patients. J Neurosurg 1994;80:461-468.

  142. Gopinath SP, Valadka AB, Uzura M, Robertson CS. Comparison of jugular venous oxygen saturation and brain tissue PO2 as monitor of cerebral ischemia after head injury. Crit Care Med 1999;27(11):2337-2345.

  143. Latronico N, Beindorf AE, Rasuti FA, Febbrari P, Stefini. Limits of intermittent jugular bulb oxygen saturation monitoring in the management of severe head trauma patients. Neurosurg 2000:46(5):1131-38.

  144. Stochetti N, Paparella A, Bridelli F et al. Cerebral venous oxygen saturation studied with bilateral samples in the internal jugular veins. Neurosurgery 1994;34:38-43.

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