Giuseppina Giannì1, Andrea Minini1, Sara Fratino1, Lorenzo Peluso1, Filippo Annoni1, Mauro Oddo2, Sophie Schuind3, Jacques Creteur1, Fabio Silvio Taccone1, Elisa Gouvêa Bogossian4. 1. Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. 2. Medical Directorate for Research, Education, and Innovation, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. 3. Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. 4. Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. elisagobog@gmail.com.
Abstract
BACKGROUND: Cerebral ischemia due to hypoxia is a major cause of secondary brain injury and is associated with higher morbidity and mortality in patients with acute brain injury. Hyperoxia could improve energetic dysfunction in the brain in this setting. Our objectives were to perform a systematic review and meta-analysis of the current literature and to assess the impact of normobaric hyperoxia on brain metabolism by using cerebral microdialysis. METHODS: We searched Medline and Scopus, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement; we searched for retrospective and prospective observational studies, interventional studies, and randomized clinical trials that performed a hyperoxia challenge in patients with acute brain injury who were concomitantly monitored with cerebral microdialysis. This study was registered in PROSPERO (CRD420211295223). RESULTS: We included a total of 17 studies, with a total of 311 patients. A statistically significant reduction in cerebral lactate values (pooled standardized mean difference [SMD] - 0.38 [- 0.53 to - 0.23]) and lactate to pyruvate ratio values (pooled SMD - 0.20 [- 0.35 to - 0.05]) was observed after hyperoxia. However, glucose levels (pooled SMD - 0.08 [- 0.23 to 0.08]) remained unchanged after hyperoxia. CONCLUSIONS: Normobaric hyperoxia may improve cerebral metabolic disturbances in patients with acute brain injury. The clinical impact of such effects needs to be further elucidated.
BACKGROUND: Cerebral ischemia due to hypoxia is a major cause of secondary brain injury and is associated with higher morbidity and mortality in patients with acute brain injury. Hyperoxia could improve energetic dysfunction in the brain in this setting. Our objectives were to perform a systematic review and meta-analysis of the current literature and to assess the impact of normobaric hyperoxia on brain metabolism by using cerebral microdialysis. METHODS: We searched Medline and Scopus, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement; we searched for retrospective and prospective observational studies, interventional studies, and randomized clinical trials that performed a hyperoxia challenge in patients with acute brain injury who were concomitantly monitored with cerebral microdialysis. This study was registered in PROSPERO (CRD420211295223). RESULTS: We included a total of 17 studies, with a total of 311 patients. A statistically significant reduction in cerebral lactate values (pooled standardized mean difference [SMD] - 0.38 [- 0.53 to - 0.23]) and lactate to pyruvate ratio values (pooled SMD - 0.20 [- 0.35 to - 0.05]) was observed after hyperoxia. However, glucose levels (pooled SMD - 0.08 [- 0.23 to 0.08]) remained unchanged after hyperoxia. CONCLUSIONS: Normobaric hyperoxia may improve cerebral metabolic disturbances in patients with acute brain injury. The clinical impact of such effects needs to be further elucidated.
Authors: M Menzel; E M Doppenberg; A Zauner; J Soukup; M M Reinert; T Clausen; P B Brockenbrough; R Bullock Journal: J Neurosurg Anesthesiol Date: 1999-10 Impact factor: 3.956
Authors: Julian Cahill; W Julian Cahill; John W Calvert; John H Calvert; John H Zhang Journal: J Cereb Blood Flow Metab Date: 2006-02-15 Impact factor: 6.200