Summary
This study investigates the effect of hypoxic brain tissue PO2 on outcome, and examines the incidence of possible causes for cerebral hypoxia.
We studied 35 patients with severe head injury (GCS ≤ 8). Age was 33.2 (±11.3) years. Total time of monitoring of PtiO2, intracranial pressure (ICP), cerebral perfusion pressure (CPP), and endtidal PCO2 (ETCO2) was 119.3 (±65.7) hours. Data were continuously recorded by a computer system. Outcome was assessed at discharge and after 6 months post injury. 56% of the patients with more than 300 minutes of PtiO2 < 10 mm Hg died, 22% had an unfavourable outcome, 22% had a favourable outcome. Cerebral hypoxia was associated with intracranial hypertension (ICP > 20mmHg) in 11.5 (±15.1)%. CPP was compromised below 60mm Hg in 16.8 (±23.4)%. Hypocarbia (ETCO2 < 28mm Hg) was present in 48.0% of the time of PtiO2 < 10mmHg. No obvious cause for cerebral hypoxia was found in 45% of the data.
These result underscore the association of cerebral hypoxia with poor neurological outcome and stress the meaning of monitoring of PtiO2 as an independent parameter in patients following TBI.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Chesnut RM, Marshall SB, Piek J, et al (1993) Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir (Wien) [Suppl] 59: 121–725
Gopinath SP, Robertson CS, Contant CF, et al (1994) Jugular venous desaturation and outcome after head injury. J Neuro Neurosurg Psychiatry 57: 717–723
Kiening K, Unterberg A, Bardt T, et al (1996) Monitoring of cerebral oxygenation in patients with severe head injuries: brain tissue PO2 versus jugular vein oxygen saturation. J Neurosurg 85: 751–757
Kohi Y, Mendelow A, Teasdale G, et al (1984) Extracranial insults and outcome in patients with acute head injury — relationship to the Glasgow Coma Scale. Injury 16: 25–29
Maas AI, Fleckenstein W, de Jong DA, et al (1993) Monitoring cerebral oxygenation: experimental studies and preliminary clinical results of continuous monitoring of cerebrospinal fluid and brain tissue oxygen tension. Acta Neurochir (Wien) [Suppl] 59: 50–57
Marshall LF, Marshall SB, Klauber MR, et al (1991) A new classification of head injury based on computerized tomography. J Neurosurg 75 [Suppl]: S14–S20
Muizelaar JP, Marmarou A, Ward JD, et al (1991) Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial. J Neurosurg 75: 731–739
Robertson C (1993) Desaturation episodes after severe head injury: influence on outcome. Acta Neurochir (Wien) [Suppl] 59: 98–101
Sheinberg M, Kanter MJ, Robertson CS, et al (1992) Continuous monitoring of jugular venous oxygen saturation in head-injured patients. J Neurosurg 76: 212–217
Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness: A practical scale. Lancet ii: 81–84
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag Wien
About this paper
Cite this paper
Bardt, T.F., Unterberg, A.W., Härtl, R., Kiening, K.L., Schneider, G.H., Lanksch, W.R. (1998). Monitoring of Brain Tissue PO2 in Traumatic Brain Injury: Effect of Cerebral Hypoxia on Outcome. In: Marmarou, A., et al. Intracranial Pressure and Neuromonitoring in Brain Injury. Acta Neurochirurgica Supplements, vol 71. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6475-4_45
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6475-4_45
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7331-2
Online ISBN: 978-3-7091-6475-4
eBook Packages: Springer Book Archive