Document Detail

Jugular bulb oximetry for prediction of vasospasm following subarachnoid hemorrhage.
MedLine Citation:
PMID:  15038475     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cerebral vasospasm adversely impacts the outcome of those suffering aneurysmal subarachnoid hemorrhage (SAH). Prediction of vasospasm could improve outcomes. We hypothesized that preclinical vasospasm would be heralded by an increase in cerebral oxygen extractions (AVDO2) which could be detected by jugular bulb oximetry. A pilot study was conducted to address this hypothesis. METHODS: Fourteen consenting patients with aneurysmal SAH, undergoing early surgery, were entered into the study. Four patients were withdrawn from the study secondary to failure of catheters or religious belief. At the time of craniotomy, a jugular bulb catheter was placed. Post-operatively, arterial and jugular bulb blood samples were taken every 12 hours to calculate AVDO2. As this was an observational study, no change in management occurred based on measurements. RESULTS: Four of 10 patients had clinical vasospasm. These patients had a significant rise in AVDO2 approximately one day prior to the onset of neurologic deficits (P<0.001). Symptoms resolved along with a significant improvement in AVDO2 on instituting hypertensive, hemo-dilutional, and hypervolemic therapy in these patients. The six patients who did not exhibit clinical vasospasm did not demonstrate significant rise in AVDO2. CONCLUSIONS: Jugular bulb oximetry is simple and cost effective. Increases in AVDO2 using this technique were predictive of clinically evident vasospasm in the subsequent hours to days. This investigation supports a larger study to assess the utility of jugular bulb oximetry in predicting vasospasm in aneurysmal SAH.
Navraj S Heran; Stephen J Hentschel; Brian D Toyota
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  31     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-24     Completed Date:  2004-05-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  80-6     Citation Subset:  IM    
Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
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MeSH Terms
Jugular Veins / metabolism*
Middle Aged
Oximetry / methods*,  statistics & numerical data
Pilot Projects
Predictive Value of Tests
Prospective Studies
Subarachnoid Hemorrhage / complications,  metabolism*
Vasospasm, Intracranial / etiology,  metabolism*

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