Evaluation of changes in brain tissue oxygen levels (PbtO2) for detection of vasospasm in patients after subarachnoid haemorrhage

Authors: Ďuriš Kamil 1;  Smrčka Martin 1;  Ševčík Pavel 2;  Gál Roman 2;  Juráň Vilém 1;  Neuman Eduard 1;  Sova Marek 1;  Vybíhal Václav 1;  Kýr Michal 3
Authors‘ workplace: Neurochirurgická klinika LF MU a FN Brno 1;  Klinika anesteziologie, resuscitace a intenzivní medicíny LF MU a FN Brno 2;  Institut biostatistiky a analýz, Masarykova univerzita Brno 3
Published in: Anest. intenziv. Med., 20, 2009, č. 2, s. 102-106
Category: Intensive Care Medicine - Original Paper


Evaluation of the impact of the admission clinical status of subarachnoid haemorrhage (SAH) patients (Hunt Hesse Score, HH3), the outcome (Glasgow Outcome Score, GOS) and the presence of vasospasm on the changes in the brain tissue oxygen levels (PbtO2), in relation to changes of FiO2 in mechanically ventilated patients.

Prospective interventional study.

Neurosurgical Department of University Hospital, Department of Anaesthesia and Resuscitation, University Hospital.

Materials and methods:
We monitored PbtO2 in patients with SAH due to aneurysm rupture for 10 days. Presence of vasospasms was repeatedly assessed with transcranial doppler (TCD). In patients on mechanical ventilation we performed the clinical trial. We increased the FiO2 to 1.0 and measured the dynamics of changes of PbtO2 simultaneously. Thus we obtained 26 continual measurements in the study group of 7 patients. The influence of vasospasm, the admission HH3 and GOS on changes of PbtO2 after an increase of FiO2 were evaluated. Mixed models analyses were used to evaluate the measured data.

In the study group we observed a significant difference in the dynamics of PbtO2 levels after an increase of FiO2 in relation to the patients‘ admission clinical status (HH3), outcome (GOS) and the presence of vasospasm. The levels of PbtO2 after an increase in FiO2 increased more in the patients with the better clinical status (HH3) and better outcome (GOS) (p < 0.001 in both parameters). In patients without vasospasm we found a significantly higher increase of PbtO2 levels after increasing FiO2 than in patients with vasospasm (p < 0.001).

The dynamics of PbtO2 levels were influenced by vasospasm. The changes of PbtO2 levels after increasing FiO2 are also associated with other factors (HH, GOS).

brain tissue oximetry – vasospasm – subarachnoid hemorrhage – aneurysm of brain vessels


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