Document Detail


The first decade of continuous monitoring of jugular bulb oxyhemoglobinsaturation: management strategies and clinical outcome.
MedLine Citation:
PMID:  9468174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To comparatively assess outcome of patients undergoing monitoring and management of cerebral extraction of oxygen along with cerebral perfusion pressure vs. outcome of patients undergoing monitoring and management of cerebral perfusion pressure alone in severe acute brain trauma. DESIGN: Prospective, interventional study. SETTING: Intensive care unit of a university hospital. PATIENTS: Adults (n = 353) with severe acute brain trauma. A group of 178 patients underwent continuous monitoring and management of cerebral extraction of oxygen and cerebral perfusion pressure, while a control group of 175 patients underwent monitoring and management of cerebral perfusion pressure only. INTERVENTIONS: Routine neuroemergency procedures. MEASUREMENTS AND MAIN RESULTS: The two groups of patients were matched with regard to age, postresuscitation Glasgow Coma Scale scores, rates of acute surgical intracranial hematomas and brain swelling, pupillary abnormalities, early hypotensive events (before intensive care monitoring), as well as initial levels of intracranial pressure and cerebral perfusion pressure. Outcome at 6 months post injury was significantly better (p < .00005) in the 178 patients undergoing monitoring and management of cerebral extraction of oxygen along with cerebral perfusion pressure, than in the control group of 175 patients undergoing monitoring and management of cerebral perfusion pressure alone. CONCLUSION: In patients with severe acute brain trauma and intracranial hypertension associated with compromised cerebrospinal fluid spaces, monitoring and managing cerebral extraction of oxygen in conjunction with cerebral perfusion pressure result in better outcome than when cerebral perfusion pressure is managed alone.
Authors:
J Cruz
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  26     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-02-26     Completed Date:  1998-02-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  344-51     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Allegheny University of the Health Sciences, Philadelphia, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Brain / metabolism
Brain Injuries / blood,  physiopathology,  therapy
Cerebrovascular Circulation
Humans
Hyperventilation / physiopathology
Intracranial Hypertension / blood,  physiopathology,  therapy
Intracranial Pressure
Jugular Veins
Monitoring, Physiologic / methods
Oxygen Consumption
Oxyhemoglobins / analysis*
Prospective Studies
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Oxyhemoglobins
Comments/Corrections
Comment In:
Crit Care Med. 1998 Feb;26(2):210-2   [PMID:  9468152 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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