Correlation between Glasgow coma scale and Jugular venous oxygen saturation in severe traumatic brain injury

A Review of Monitoring Methods for Cerebral Blood Oxygen Saturation

In recent years, cerebral blood oxygen saturation has become a key indicator during the perioperative period. Cerebral blood oxygen saturation monitoring is conducive to the early diagnosis and treatment of cerebral ischemia and hypoxia. The present study discusses the three most extensively used clinical methods for cerebral blood oxygen saturation monitoring from different aspects: working principles, relevant parameters, current situations of research, commonly used equipment, and relative advantages of different methods. Furthermore, through comprehensive comparisons of the methods, we find that near-infrared spectroscopy (NIRS) technology has significant potentials and broad applications prospects in terms of cerebral oxygen saturation monitoring. Despite the current NIRS technology, the only bedside non-invasive cerebral oxygen saturation monitoring technology, still has many defects, it is more in line with the future development trend in the field of medical and health, and will become the main method gradually.

Traumatic Brain Injury Update

Traumatic brain injury is a devastating, life-changing event in most cases. After the primary brain insult, it is helpful to use evidence-based monitoring techniques to guide implementation of essential interventions to minimize secondary injury and thereby improve patient outcomes. An update on multimodal neuromonitoring is provided in this narrative review, with discussion of tools and techniques currently used in the treatment of patients with brain injury. Neuroprotective treatments, from the well-studied targeted temperature management to new potential therapeutics under investigation, such as glyburide, also are presented.

Quantification of normal cerebral oxygen extraction and oxygen metabolism by phase-based MRI susceptometry: evaluation of repeatability using two different imaging protocols

INTRODUCTION

Global oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO₂ ) were quantified in a test-retest study. Cerebral blood flow (CBF) data, required for CMRO₂ estimation, were obtained using dynamic susceptibility contrast MRI (DSC-MRI). OEF and CMRO₂ were quantified using two separate data sets, that is, conventional high-resolution (HR) gradient echo (GRE) phase maps as well as echo planar imaging (EPI) phase maps taken from the baseline (precontrast) part of the DSC-MRI time series. The EPI phase data were included to elucidate whether an extra HR-GRE scan is needed to obtain information about OEF and CMRO₂ , or if this information can be extracted from the DSC-MRI experiment only.

METHODS

Twenty healthy volunteers were scanned using 3 T MRI on two occasions. Oxygen saturation levels were obtained from phase data measured in the great cerebral vein of Galen, based on HR-GRE as well as EPI phase maps. In combination with DSC-MRI CBF, this allowed for calculation of OEF and CMRO₂ .

RESULTS

High-resolution-gradient echo- and EPI-based phase images resulted in similar OEF spread and repeatability, with coefficients of variation/intraclass correlation coefficients of 0·26/0·95 and 0·23/0·81, respectively. Absolute OEF values (HR-GRE: 0·40 ± 0·11, EPI: 0·35 ± 0·08) were consistent with literature data. CMRO₂ showed similar repeatability, somewhat increased spread and reasonable absolute values (HR-GRE: 3·23 ± 1·26 ml O₂ /100 g min^-1 , EPI: 2·79 ± 0·89 ml O₂ /100 g min^-1 ).

DISCUSSION

In general, the results obtained by HR-GRE and EPI showed comparable characteristics. The EPI methodology could potentially be improved using a slightly modified DSC-MRI protocol (e.g. with regard to spatial resolution and slice gap).