METZ, C and BEIN, T and RENG, M and TAEGER, K (1993) CEREBROVENOUS OXIMETRY IN PATIENTS WITH HEAD-INJURY. ANASTHESIOLOGIE & INTENSIVMEDIZIN, 34 (11). pp. 345-355. ISSN 0170-5334,
Full text not available from this repository.Abstract
Continuous jugular venous oximetry is a procedure requiring but little equipment, with the aid of which the ratio of global cerebral oxygen supply to global cerebral oxygen consumption can be measured ''on-line''. For this purpose, the internal retrograde cannulation of the jugular vein is done and a fibreoptic catheter placed in the bulb of the internal jugular vein. Continuous cerebrovenous oximetry requires a high level of attention. Validation of the measured value indicated prior to initiating therapeutic measures is an absolute must. Some experience of the technique is required in order to be able reliably to recognize artefacts. The use of an introducer set leads to appreciably more stable measurements, and makes possible the subsequent repositioning in the event of a dislodgement of the tip of the catheter. The indication for cerebrovenous oximetry includes all those diseases associated with the risk of a ''global'' cerebral ischaemia. In patients with severe head injury, continuous monitoring of the SJO2 permits immediate monitoring of the therapeutic measures aimed at modifying the CBF/CMRO2 ratio,for example, elevation of the CPP, modification of the ventilation pattern, drug treatment. The question as to a suitable cerebral oxygen supply must be answered ''on-line''. Undesired cerebral ischaemia due to treatment of the elevated intracranial pressure by means of hyperventilation, elevation of the trunk and the use of osmodiuretics, can be identified immediately and corrected by the application of selected measures. The simultaneous monitoring of the SaO2 and endexpiratory CO2 partial pressure permits the diagnosis of an hypoxic or hypercapnic increase of ICP, thus permitting the application of causal therapy. The equipment requirement is about the same as that needed for continuous mixed venous oximetry in the pulmonary artery. In order to further reduce catheter-associated artefacts, technical improvements to the catheter material available would be desirable. It is possible that, in the near future, continuous cerebrovenous oximetry will form a permanent part of the standard procedure for the treatment of patients with severe head injuries.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; HEAD INJURIES; OXIMETRY; CEREBRAL ISCHEMIA, TRANSIENT; EQUIPMENT AND SUPPLIES; JUGULAR VEINS |
| Depositing User: | Dr. Gernot Deinzer |
| Last Modified: | 19 Oct 2022 08:42 |
| URI: | https://pred.uni-regensburg.de/id/eprint/53682 |
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