Zerebrale sauerstoffreaktivitätsbestimmung - Ein einfacher test mit potentiell prognostischer relevanz

Translated title of the contribution: Oxygen reactivity in patients after severe head injury - A prognostic tool?

M. Menzel, E. M.R. Doppenberg, A. Zauner, J. Soukup, D. Henze, T. Clausen, A. Rieger, R. Bullock, J. Radke

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Brain tissue oximetry (p tiO 2) using flexible micro-polarographic electrodes is a loco-regional approach to monitor oxygen supply to the injured brain, after neuronal damage. In patients after severe head injury (SHI), disturbances of CBF and CO 2 related vasoconstriction have been demonstrated. CO 2 reactivity testing may assist to determine outcome in these patients. Not much information is available on the preservation of vasoreactivity to arterial hyperoxia after neuronal damage. Therefore, we studied the response of p tiO 2 in 7 piglets and in 14 patients on day one after trauma to 100% FiO 2 ventilation (O 2rea) and analyzed the 3 month outcome using the Glasgow-Outcome-Score (GOS). In the animal study, we placed a Paratrend 7 (P7) sensor for p tiO 2 measurements in the non injured frontal white matter. The animals were anesthetized and mechanically ventilated. FiO 2 was increased from 30 (±5)% to 100% over a period of 5 minutes. In patients, we placed the P7 probe in the frontal lobe. FiO 2 was increased from 35 (±5)% to 100% over a period of 6 hours. O 2rea was tested by calculating the percentage change of p tiO 2 during 100% FiO 2 ventilation, compared to the baseline value of 35% FiO 2. By analyzing the patient outcome, we were able to define two patient populations according to the GOS at three month (Group I: favorable outcome [GOS 0-2]; Group II: poor outcome [GOS 3-4]). For the non-injured brain tissue in animals we revealed an O 2rea=0.21 (±0.12). Patients: Group I: O 2rea=0.4 (±0.16); Group II: 0.9 (±0.6). Group I and II were statistical significant different (p<0.05; unpaired t-test). Oxygen reactivity in severely head patients is a simple test with prognostic value using p tiO 2 measurement. These results may be explained by the close relationship of CBF disturbances to oxygen vasoreactivity after traumatic brain injury. The O 2rea in animals without neuronal damage is smaller than in patients after SHI. We speculate, the animal data could be considered as normal value of O 2rea in non injured brain tissue.

Translated title of the contributionOxygen reactivity in patients after severe head injury - A prognostic tool?
Original languageGerman
Pages (from-to)181-187
Number of pages7
JournalZentralblatt fur Neurochirurgie
Volume61
Issue number4
DOIs
StatePublished - 2000

Keywords

  • Brain tissue oximetry
  • Hyperoxia
  • Outcome
  • SHI

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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