Detection of cerebral hypoperfusion with a dynamic hyperoxia test using brain oxygenation pressure monitoring

Autor: Thomas Gargadennec, Gioconda Ferraro, Rudy Chapusette, Xavier Chapalain, Elisa Bogossian, Morgane Van Wettere, Lorenzo Peluso, Jacques Creteur, Olivier Huet, Niloufar Sadeghi, Fabio Silvio Taccone
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Critical Care, Vol 26, Iss 1, Pp 1-10 (2022)
Druh dokumentu: article
ISSN: 1364-8535
DOI: 10.1186/s13054-022-03918-0
Popis: Abstract Introduction Brain multimodal monitoring including intracranial pressure (ICP) and brain tissue oxygen pressure (PbtO2) is more accurate than ICP alone in detecting cerebral hypoperfusion after traumatic brain injury (TBI). No data are available for the predictive role of a dynamic hyperoxia test in brain-injured patients from diverse etiology. Aim To examine the accuracy of ICP, PbtO2 and the oxygen ratio (OxR) in detecting regional cerebral hypoperfusion, assessed using perfusion cerebral computed tomography (CTP) in patients with acute brain injury. Methods Single-center study including patients with TBI, subarachnoid hemorrhage (SAH) and intracranial hemorrhage (ICH) undergoing cerebral blood flow (CBF) measurements using CTP, concomitantly to ICP and PbtO2 monitoring. Before CTP, FiO2 was increased directly from baseline to 100% for a period of 20 min under stable conditions to test the PbtO2 catheter, as a standard of care. Cerebral monitoring data were recorded and samples were taken, allowing the measurement of arterial oxygen pressure (PaO2) and PbtO2 at FiO2 100% as well as calculation of OxR (= ΔPbtO2/ΔPaO2). Regional CBF (rCBF) was measured using CTP in the tissue area around intracranial monitoring by an independent radiologist, who was blind to the PbtO2 values. The accuracy of different monitoring tools to predict cerebral hypoperfusion (i.e., CBF
Databáze: Directory of Open Access Journals