TY - JOUR
T1 - Monitoring of Brain and Systemic Oxygenation in Neurocritical Care Patients
AU - The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring
AU - Oddo, Mauro
AU - Bösel, Julian
AU - Le Roux, Peter
AU - Menon, David K.
AU - Vespa, Paul
AU - Citerio, Giuseppe
AU - Bader, Mary Kay
AU - Brophy, Gretchen M.
AU - Diringer, Michael N.
AU - Stocchetti, Nino
AU - Videtta, Walter
AU - Armonda, Rocco
AU - Badjatia, Neeraj
AU - Chesnut, Randal
AU - Chou, Sherry
AU - Claassen, Jan
AU - Czosnyka, Marek
AU - De Georgia, Michael
AU - Figaji, Anthony
AU - Fugate, Jennifer
AU - Helbok, Raimund
AU - Horowitz, David
AU - Hutchinson, Peter
AU - Kumar, Monisha
AU - McNett, Molly
AU - Miller, Chad
AU - Naidech, Andrew
AU - Oddo, Mauro
AU - Olson, Dai Wai
AU - O’Phelan, Kristine
AU - Provencio, Javier
AU - Puppo, Corina
AU - Riker, Richard
AU - Robertson, Claudia
AU - Schmidt, J. Michael
AU - Taccone, Fabio
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media New York.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Maintenance of adequate oxygenation is a mainstay of intensive care, however, recommendations on the safety, accuracy, and the potential clinical utility of invasive and non-invasive tools to monitor brain and systemic oxygenation in neurocritical care are lacking. A literature search was conducted for English language articles describing bedside brain and systemic oxygen monitoring in neurocritical care patients from 1980 to August 2013. Imaging techniques e.g., PET are not considered. A total of 281 studies were included, the majority described patients with traumatic brain injury (TBI). All tools for oxygen monitoring are safe. Parenchymal brain oxygen (PbtO2) monitoring is accurate to detect brain hypoxia, and it is recommended to titrate individual targets of cerebral perfusion pressure (CPP), ventilator parameters (PaCO2, PaO2), and transfusion, and to manage intracranial hypertension, in combination with ICP monitoring. SjvO2 is less accurate than PbtO2. Given limited data, NIRS is not recommended at present for adult patients who require neurocritical care. Systemic monitoring of oxygen (PaO2, SaO2, SpO2) and CO2 (PaCO2, end-tidal CO2) is recommended in patients who require neurocritical care.
AB - Maintenance of adequate oxygenation is a mainstay of intensive care, however, recommendations on the safety, accuracy, and the potential clinical utility of invasive and non-invasive tools to monitor brain and systemic oxygenation in neurocritical care are lacking. A literature search was conducted for English language articles describing bedside brain and systemic oxygen monitoring in neurocritical care patients from 1980 to August 2013. Imaging techniques e.g., PET are not considered. A total of 281 studies were included, the majority described patients with traumatic brain injury (TBI). All tools for oxygen monitoring are safe. Parenchymal brain oxygen (PbtO2) monitoring is accurate to detect brain hypoxia, and it is recommended to titrate individual targets of cerebral perfusion pressure (CPP), ventilator parameters (PaCO2, PaO2), and transfusion, and to manage intracranial hypertension, in combination with ICP monitoring. SjvO2 is less accurate than PbtO2. Given limited data, NIRS is not recommended at present for adult patients who require neurocritical care. Systemic monitoring of oxygen (PaO2, SaO2, SpO2) and CO2 (PaCO2, end-tidal CO2) is recommended in patients who require neurocritical care.
KW - Brain oxygen
KW - Carbon dioxide
KW - Jugular oxygen saturation
KW - Near-infrared spectroscopy
KW - Neurocritical care
KW - Systemic oxygenation
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U2 - 10.1007/s12028-014-0024-6
DO - 10.1007/s12028-014-0024-6
M3 - Article
C2 - 25208670
AN - SCOPUS:84925463220
SN - 1541-6933
VL - 21
SP - 103
EP - 120
JO - Neurocritical Care
JF - Neurocritical Care
IS - 2
ER -