Neurologic outcomes with cerebral oxygen monitoring in traumatic brain injury

Background. Optimizing cerebral oxygenation is advocated to Improve outcome in head-injured patients. The purpose of this study was to compare outcomes in brain-injured patients treated with 2 types of monitors. Methods. Patients with traumatic brain injury and a Glasgow Coma Scale score<8 were identified 071 admission. A polarographic cerebral oxygen/pressure monitor (Licox) or fiberoptic intracranial pressure monitor (Camino) was inserted tin. evidence-based algorithm treatment was Implemented Elements from the prehospital and emergency department records and the first 10 days of intensive care unit (ICU) care were collected Glasgow Outcome Scores (GOS) were determined every 3 months after discharge. Results. Over a 3-year period, 145 patient, were entered into the study; 81 patients In. the Lucox group and 64 patients in the Camino group. Mortality, hospital length of stay, and ICU length of stay were equivalent In the 2 groups. More patients In the Lucox group achieved a moderate/recovered GOS at 3 months than in the Camino Group (79% vs 61%, P = 09) Conclusion.. Three-month GOS revealed a clinically meaningful 18% benefit in patients undergoing cerebial oxygen monitoring and optimization. Six-month outcomes were also better Unfortunately, these important differences did-not reach significance Continued study of the benefits of cerebral oxygen. monitoring is warranted. (Surgery 2009:146:585-91)