Mathews Jacob1, M N Kale2, Shahabaz Hasnain3. 1. Brig i/c Adm, (Military Hospital Cardio Thoracic Centre), Pune 411040, India. 2. Graded Specialist (Anaesthesiology), 162 Military Hospital, C/o 99 APO, India. 3. Deputy Commandant, Command Hospital (Eastern Command), Kolkata, India.
Abstract
BACKGROUND: Traumatic brain injury (TBI) is known to be an important reason for the increase in disabilities and deaths worldwide. Studies have demonstrated that brain tissue oxygen (PO2) monitoring reduces mortality significantly but is a invasive method of monitoring. Therefore, there is a need to monitor cerebral ischemia in TBI by noninvasive methods. The study aims to correlate cerebral co-oximetry and possible outcomes in patients with TBI. METHODS: The study included 78 patients with TBI admitted in intensive care unit (ICU) with glascow coma scale (GCS) of 8 or less than 8. Near-infrared spectroscopy monitor is applied to the patients immediately after admission to ICU; readings are noted every 4 hours up to first 48 hours, and outcomes studied as survival or neurological deficit are noted at 28 days. RESULTS: A total of 12 (15.4%) deaths were seen in this study. Survived patients were further divided into good recovery 33 (42.3%), moderate disability 21(26.9%), major disability 8 (10.3%), and persistent vegetative state 4 (5.1%). The rSO2 values in surviving patients were ranging from mean of 60.74% (standard deviation [SD] 4.38) to a mean of 64.98% (SD 5.01), and the mean rSO2 values in patients who died were ranging from a mean of 52.17% (SD 4.11) to a mean of 37.17% (SD 12.48). Lower rSO2 values were correlating significantly with worse neurological outcome or death by using two independent sample t-test (p < 0.001). CONCLUSION: Cerebral co-oximetry is a simple noninvasive method for predicting the outcomes in TBI and can be used to guide the management of these patients.
BACKGROUND: Traumatic brain injury (TBI) is known to be an important reason for the increase in disabilities and deaths worldwide. Studies have demonstrated that brain tissue oxygen (PO2) monitoring reduces mortality significantly but is a invasive method of monitoring. Therefore, there is a need to monitor cerebral ischemia in TBI by noninvasive methods. The study aims to correlate cerebral co-oximetry and possible outcomes in patients with TBI. METHODS: The study included 78 patients with TBI admitted in intensive care unit (ICU) with glascow coma scale (GCS) of 8 or less than 8. Near-infrared spectroscopy monitor is applied to the patients immediately after admission to ICU; readings are noted every 4 hours up to first 48 hours, and outcomes studied as survival or neurological deficit are noted at 28 days. RESULTS: A total of 12 (15.4%) deaths were seen in this study. Survived patients were further divided into good recovery 33 (42.3%), moderate disability 21(26.9%), major disability 8 (10.3%), and persistent vegetative state 4 (5.1%). The rSO2 values in surviving patients were ranging from mean of 60.74% (standard deviation [SD] 4.38) to a mean of 64.98% (SD 5.01), and the mean rSO2 values in patients who died were ranging from a mean of 52.17% (SD 4.11) to a mean of 37.17% (SD 12.48). Lower rSO2 values were correlating significantly with worse neurological outcome or death by using two independent sample t-test (p < 0.001). CONCLUSION: Cerebral co-oximetry is a simple noninvasive method for predicting the outcomes in TBI and can be used to guide the management of these patients.
Authors: Michael F Stiefel; Alejandro Spiotta; Vincent H Gracias; Alicia M Garuffe; Oscar Guillamondegui; Eileen Maloney-Wilensky; Stephanie Bloom; M Sean Grady; Peter D LeRoux Journal: J Neurosurg Date: 2005-11 Impact factor: 5.115
Authors: Bruce A Crookes; Stephen M Cohn; Scott Bloch; Jose Amortegui; Ronald Manning; Pam Li; Matthew S Proctor; Ali Hallal; Lorne H Blackbourne; Robert Benjamin; Dror Soffer; Fahim Habib; Carl I Schulman; Robert Duncan; Kenneth G Proctor Journal: J Trauma Date: 2005-04
Authors: Chantal W P M Hukkelhoven; Ewout W Steyerberg; Anneke J J Rampen; Elana Farace; J Dik F Habbema; Lawrence F Marshall; Gordon D Murray; Andrew I R Maas Journal: J Neurosurg Date: 2003-10 Impact factor: 5.115