RT Journal Article
T1 Cerebral perfusion pressure and risk of brain hypoxia in severe head injury: a prospective observational study
A1 Marín-Caballos, Antonio J.
A1 Murillo-Cabezas, Francisco
A1 Cayuela-Domínguez, Aurelio
A1 Domínguez-Roldán, Jose M.
A1 Rincón-Ferrari, M. Dolores
A1 Valencia-Anguita, Julio
A1 Flores-Cordero, Juan M.
A1 Muñoz-Sánchez, M Angeles
K1 Presión Sanguínea
K1 Traumatismos Craneocerebrales
K1 Cuidados Críticos
K1 Hipoxia Encefálica
K1 Telencéfalo
AB INTRODUCTIONHigher and lower cerebral perfusion pressure (CPP) thresholds have been proposed to improve brain tissue oxygen pressure (PtiO2) and outcome. We study the distribution of hypoxic PtiO2 samples at different CPP thresholds, using prospective multimodality monitoring in patients with severe traumatic brain injury.METHODSThis is a prospective observational study of 22 severely head injured patients admitted to a neurosurgical critical care unit from whom multimodality data was collected during standard management directed at improving intracranial pressure, CPP and PtiO2. Local PtiO2 was continuously measured in uninjured areas and snapshot samples were collected hourly and analyzed in relation to simultaneous CPP. Other variables that influence tissue oxygen availability, mainly arterial oxygen saturation, end tidal carbon dioxide, body temperature and effective hemoglobin, were also monitored to keep them stable in order to avoid non-ischemic hypoxia.RESULTSOur main results indicate that half of PtiO2 samples were at risk of hypoxia (defined by a PtiO2 equal to or less than 15 mmHg) when CPP was below 60 mmHg, and that this percentage decreased to 25% and 10% when CPP was between 60 and 70 mmHg and above 70 mmHg, respectively (p < 0.01).CONCLUSIONOur study indicates that the risk of brain tissue hypoxia in severely head injured patients could be really high when CPP is below the normally recommended threshold of 60 mmHg, is still elevated when CPP is slightly over it, but decreases at CPP values above it.
PB BioMed Central
YR 2005
FD 2005-10-14
LK http://hdl.handle.net/10668/1690
UL http://hdl.handle.net/10668/1690
LA en
NO Marín-Caballos AJ, Murillo-Cabezas F, Cayuela-Domínguez A, Domínguez-Roldán JM, Rincón-Ferrari MD, Valencia-Anguita J, et al. Cerebral perfusion pressure and risk of brain hypoxia in severe head injury: a prospective observational study. Crit Care. 2005; 9(6):R670-6
NO Evaluation Studies; Journal Article;
DS RISalud
RD Apr 17, 2025