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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Online assessment of brain tissue oxygen pressure reactivity in traumatic brain injury and subarachnoid hemorrhage

Online-Erfassung der zerebralen Gewebesauerstoff-Druckreaktivität bei Schädel-Hirn-Trauma und Subarachnoidalblutung

Meeting Abstract

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  • corresponding author Martin Soehle - Klinik für Anästhesiologie und Spezielle Intensivmedizin, Universitätsklinikum Bonn, Bonn
  • M. Jaeger - Klinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig
  • J. Meixensberger - Klinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.10.08

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0105.shtml

Published: April 23, 2004

© 2004 Soehle et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Monitoring of brain tissue oxygenation (ptiO2) enables early diagnosis of secondary cerebral ischemia and may guide a cerebral perfusion pressure (CPP)-orientated therapy. The aim of our study was to explain the concept of ptiO2 pressure reactivity, defined as the ability of the brain to maintain ptiO2 despite changes in CPP, and to show the different states of ptiO2 pressure reactivity we found.

Methods

Microcatheters to assess ptiO2 and intracranial pressure were implanted into cerebral 'tissue at risk' of patients suffering from traumatic brain injury or subarachnoid hemorrhage. By using a multimodal neuromonitoring setup and in-house built software we assessed and displayed online the relationship between ptiO2 and CPP based on a data buffer consisting of 12 hours.

Results

Depending on the linear regression slope (bptiO2=Δ ptiO2/Δ CPP), we defined the state of ptiO2 pressure reactivity as preserved (0?bptiO2?1/6), moderate (1/6<bptiO2?1/3) or inverse (bptiO2<0). In preserved ptiO2 pressure reactivity, an elevation in CPP is ineffective to raise ptiO2. In contrast, an increase in CPP elevates ptiO2 more pronounced in impaired than in moderate ptiO2 pressure reactivity, but decreases ptiO2 in inverse ptiO2 pressure reactivity.

Conclusions

Online assessment of ptiO2 pressure reactivity gives valuable information on which patient will benefit from an increase in CPP and which CPP should be achieved to do so.