Brain tissue oxygen monitoring in pediatric patients with severe traumatic brain injury

Michael F. Stiefel, Joshua D. Udoetuk, Phillip B. Storm, Leslie N. Sutton, Heakyung Kim, Troy E. Dominguez, Mark A. Helfaer, Jimmy W. Huh

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Object. Intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring are fundamental to the management of severe traumatic brain injury (TBI). In adults, brain tissue oxygen monitoring (specifically PO2) and treatment have been shown to be safe additions to conventional neurocritical care and are associated with improved outcome. Brain tissue oxygen monitoring, however, has not been described in pediatric patients with TBI. In this report, the authors present preliminary experience with the use of ICP and PO 2 monitoring in this population. Methods. Pediatric patients (age < 18 years) with severe TBI (Glasgow Coma Scale score < 8) admitted to a Level 1 trauma center who underwent ICP and PO2 monitoring were evaluated. Therapy was directed at maintaining ICP below 20 mm Hg and age-appropriate CPP (≥ 40 mm Hg). Data obtained in six patients (two girls and four boys ranging in age from 6-16 years) were analyzed. Brain tissue oxygen levels were significantly higher (p < 0.01) at an ICP of less than 20 mm Hg (PO2 29.29 ± 7.17 mm Hg) than at an ICP of greater than or equal to 20 mm Hg (PO2 22.83 ± 13.85 mm Hg). Significant differences (p < 0.01) were also measured when CPP was less than 40 mm Hg (PO2 2.53 ± 7.98 mm Hg) and greater than or equal to 40 mm Hg (PO2 28.97 ± 7.85 mm Hg). Conclusions. Brain tissue oxygen monitoring may be a safe and useful addition to ICP monitoring in the treatment of pediatric patients with severe TBI.

Original languageEnglish (US)
Pages (from-to)281-286
Number of pages6
JournalJournal of neurosurgery
Volume105 PEDIATRICS
Issue numberSUPPL. 4
DOIs
StatePublished - Oct 2006
Externally publishedYes

Keywords

  • Brain tissue oxygen monitoring
  • Cerebral perfusion pressure
  • Intracranial pressure
  • Pediatric neurosurgery
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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