Jugular venous desaturation and outcome after head injury.

Abstract

Early experience with continuous

Near-Infrared Spectroscopy in the Monitoring of Adult Traumatic Brain Injury: A Review

“…[41][42][43][44] The relationship and correlation of cerebral NIRS to this modality (inside and outside the context of TBI) has been reported, with positive results in multiple small observational investigations in children. [45][46][47] As such, evidence for how changes in cerebral NIRS parameters reflect and predict changes in jugular bulb oximetry is sparse, particularly within the context of TBI.…”

Intracranial hypertension and cerebral ischemia after severe traumatic brain injury

“…If the brain is hypoperfused, O 2 extraction will be increased, and SjvO 2 will be reduced. Intracranial hypertension was the most common cause of jugular venous desaturation reported in a prospective study of 116 patients with severe head injury, 7 accounting for 44% of the total number of episodes. If CBF is appropriate for the brain's metabolic requirement, then SjvO 2 will be normal.…”

Untitled

“…In other studies evaluating continuous jugular oxygen saturation after head injury, multivariate analysis has indicated that after adjustment for outcome determinants such as age, ICP, and GCS score, the number of desaturations continues to demonstrate a significant association with outcome: one episode of desaturation doubled the risk of a poor outcome, whereas multiple desaturations were associated with a 14-fold increase in the risk of poor outcome. [18] Whether the predictive information provided by AVDO 2 monitoring is a useful management tool is not addressed in this study. The ability to predict outcome, however, is important because when outcome can be accurately predicted, management can be directed at potentially avoidable deleterious factors.…”

“…[8,10,11,35,49] Jugular saturation monitors may also detect transient episodes of cerebral hypoxia from potentially preventable systemic causes such as hypotension, hypoxia, fever, or seizures. [11,18,40] The identification of inadequate cerebral oxygenation is important in the management of cases of head injury. The validity of using CPP as a measure of cerebral oxygenation becomes limited when autoregulatory mechanisms are disturbed and it also leads one to ignore other potential causes of cerebral ischemia after head injury.…”