The Oxygen Reactivity Index and Its Relation to Sensor Technology in Patients with Severe Brain Lesions

Dengler, Julius; Frenzel, Christin; Vajkoczy, Peter; Horn, Peter A.; Wolf, Stefan

doi:10.1007/s12028-012-9686-0

Cited by 21 publications

(9 citation statements)

References 18 publications

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“…In the setting of SAH, for example, ORx using the Licox monitor is more predictive of delayed infarction than brain hypoxia 44 and may be independently associated with outcome. 45 In general, the Orx and Prx tend to correlate with one another (at least when using the Licox monitor; some differences have been shown when using the Neurotrend 46 or the Neurovent-PTO monitors 47 ).…”

Section: Methods To Measure Brain Ptio2mentioning

confidence: 97%

Brain Tissue Oxygen Monitoring in Neurocritical Care

De Georgia

2014

J Intensive Care Med

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Brain injury results from ischemia, tissue hypoxia, and a cascade of secondary events. The cornerstone of neurocritical care management is optimization and maintenance of cerebral blood flow (CBF) and oxygen and substrate delivery to prevent or attenuate this secondary damage. New techniques for monitoring brain tissue oxygen tension (PtiO2) are now available. Brain PtiO2 reflects both oxygen delivery and consumption. Brain hypoxia (low brain PtiO2) has been associated with poor outcomes in patients with brain injury. Strategies to improve brain PtiO2 have focused mainly on increasing oxygen delivery either by increasing CBF or by increasing arterial oxygen content. The results of nonrandomized studies comparing brain PtiO2-guided therapy with intracranial pressure/cerebral perfusion pressure-guided therapy, while promising, have been mixed. More studies are needed including prospective, randomized controlled trials to assess the true value of this approach. The following is a review of the physiology of brain tissue oxygenation, the effect of brain hypoxia on outcome, strategies to increase oxygen delivery, and outcome studies of brain PtiO2-guided therapy in neurocritical care.

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Section: Methods To Measure Brain Ptio2mentioning

confidence: 97%

Brain Tissue Oxygen Monitoring in Neurocritical Care

De Georgia

2014

J Intensive Care Med

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“…However, any beneficial effects of treatment guided by the ORx on clinical outcome of traumatic brain injury patients remain controversial at present. 40 – 42) …”

Section: Monitoring Of Cerebral Oxygenationmentioning

confidence: 99%

Update on Intensive Neuromonitoring for Patients with Traumatic Brain Injury: A Review of the Literature and the Current Situation

Koizumi

Suehiro

Fujiyama

et al. 2014

Neurol. Med. Chir.(Tokyo)

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Intracranial pressure (ICP) measurements are fundamental in the present protocols for intensive care of patients during the acute stage of severe traumatic brain injury. However, the latest report of a large scale randomized clinical trial indicated no association of ICP monitoring with any significant improvement in neurological outcome in severely head injured patients. Aggressive treatment of patients with therapeutic hypothermia during the acute stage of traumatic brain injury also failed to show any significant beneficial effects on clinical outcome. This lack of significant results in clinical trials has limited the therapeutic strategies available for treatment of severe traumatic brain injury. However, combined application of different types of neuromonitoring, including ICP measurement, may have potential benefits for understanding the pathophysiology of damaged brains. The combination of monitoring techniques is expected to increase the precision of the data and aid in prevention of secondary brain damage, as well as assist in determining appropriate time periods for therapeutic interventions. In this study, we have characterized the techniques used to monitor patients during the acute severe traumatic brain injury stage, in order to establish the beneficial effects on outcome observed in clinical studies conducted in the past and to follow up any valuable clues that point to additional strategies for aggressive management of these patients.

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“…PbtO2-based autoregulation monitoring using an index named "ORx" has also been investigated in SAH patients [54,59,312,313]. The authors report that "ORx values from days 5 and 6 after SAH carried predictive value for the occurrence of delayed infarction but before this event ultimately occurred" [54].…”

Section: Applied Physiologymentioning

confidence: 99%

“…A peer reviewed, yet preliminary formal comparison in eleven SAH and TBI patients with simultaneously recorded Licox and Neurovent pbtO2 for ORx calculation reports a mean ORx difference of 0,1 with Licox producing higher values [313]. ORx agreement was between -0.6 to +0.7.…”

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confidence: 99%

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Systematic and Comprehensive Literature Review of Publications on Direct Cerebral Oxygenation Monitoring

Lang

Jaeger²

2013

TOCCMJ

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This review has been compiled to assess publications related to the clinical application of direct cerebral tissue oxygenation (pbtO2) monitoring published in international, peer-reviewed scientific journals, or major meeting reports published as journal supplements. Its goal was to extract relevant, i.e. positive and negative, information on indications, clinical application, safety issues and impact on clinical situations, as well as treatment strategies in neurosurgery, neurosurgical anaesthesiology, neurosurgical intensive care, neurology, and related specialties. For completeness' sake it also presents related basic science research and case reports. This review is an update of its previous edition published elsewhere in 2007. This review reflects publications from 2004 to 2012. Only relevant publications prior to 2004, which explicitly addressed or systematically examined the above issues, are included in this review and are listed in the reference section. Based on 349 citations it is the most comprehensive review available on direct cerebral oxygen monitoring to this date.Keywords: Review, cerebral oxygenation, raumedic, licox, neurotrend, cerebral partial pressure of oxygen, brain tissue oxygenation. METHODSThis review is based on a systematic "Medline" literature search using the following search terms: licox, neurotrend, neurovent, raumedic, brain tissue oxygen, brain tissue oxygenation, cerebral oxygenation, cerebral tissue oxygen, cerebral partial pressure of oxygen, btO2, ptiO2, pti(O)2, ptiO(2), pbrO2, PBr(O2), P(bt)O(2), P(br)O(2), PbrO(2), BTpO2, tP(O2), PbO2, PbtO2, Pbto, PbtO(2).Only few publications were not retrieved using this technique. They were, however, identified through personal communication with scientists in the field, meeting proceedings and reviewer assignments. This strategy provided sufficient certainty that relevant papers have not been missed. Unpublished meeting abstracts and published conference proceedings were excluded for this review expect for few which provided comparative studies between different probes. To address relevant matters, related to specific pbtO2 issues, selected non-peer reviewed papers published in supplements were also used only when no other peer-reviewed information was available. RESULTSThis review is based on a previous review [1]. It is currently based on 349 papers, 274 more papers compared to its previous version in 2007, which warrants the update.

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The Oxygen Reactivity Index and Its Relation to Sensor Technology in Patients with Severe Brain Lesions

Cited by 21 publications

References 18 publications

Brain Tissue Oxygen Monitoring in Neurocritical Care

Brain Tissue Oxygen Monitoring in Neurocritical Care

Update on Intensive Neuromonitoring for Patients with Traumatic Brain Injury: A Review of the Literature and the Current Situation

Systematic and Comprehensive Literature Review of Publications on Direct Cerebral Oxygenation Monitoring

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