Monitoring of Brain and Systemic Oxygenation in Neurocritical Care Patients

The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)103-120
Number of pages18
JournalNeurocritical Care
Volume21
Issue number2
DOIs
Publication statusPublished - Oct 1 2014

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Keywords

  • Brain oxygen
  • Carbon dioxide
  • Jugular oxygen saturation
  • Near-infrared spectroscopy
  • Neurocritical care
  • Systemic oxygenation

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring (2014). Monitoring of Brain and Systemic Oxygenation in Neurocritical Care Patients. Neurocritical Care, 21(2), 103-120. https://doi.org/10.1007/s12028-014-0024-6