Cerebral oxygenation monitoring by near-infrared spectroscopy is not clinically useful in patients with severe closed-head injury: a comparison with jugular venous bulb oximetry

Critical Care Medicine
S B LewisP L Reilly

Abstract

To compare continuous jugular venous bulb oximetry and cerebral near-infrared spectroscopy in patients with severe closed head injury. A prospective observational study. Intensive care unit of a major teaching hospital. Adults (n = 10) with severe closed-head injury (Glasgow Coma Scale score of < or = 8). None. Jugular venous bulb oximetry, cerebral near-infrared spectroscopy, and cerebral perfusion pressure were measured continuously. A total of 3,691 paired measurements of near-infrared spectroscopy and jugular venous bulb oximetry were analyzed. Poor correlation (r2 = .04) between paired measurements and wide limits of agreement (-13% to +21%) were demonstrated. The mean difference between measurements was +/- 4% and the standard deviation of the mean difference was +/- 8.69%. The data were subsequently grouped according to three clinically significant subgroups of jugular venous bulb oxygen saturation reflecting low ( < 55%), normal (55% to 75%) and high ( > 75%) saturation values. Poor correlation and wide limits of agreement between the two methods of measurement were observed in all groups. Values recorded by near-infrared spectroscopy did not significantly change between the groups, and 14 clinically significant episode...Continue Reading

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Related Concepts

Teens
Diastolic Blood Pressure
Brain Chemistry
Cerebrovascular Circulation
Temporal Region Trauma
Intracranial Pressure
Structure of Jugular Vein
Oximetry, Pulse
Dioxygen
Infrared Spectrophotometry

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