Neuromonitoring: Brain oxygenation and microdialysis

被引:21
作者
Asita S. Sarrafzadeh
Karl L. Kiening
Andreas W. Unterberg
机构
[1] Department of Neurosurgery, Charite Camp. Virchow Medical Clinic, Humboldt University of Berlin, 13353 Berlin
关键词
Cerebral Perfusion Pressure; Cerebral Oxygenation; Severe Head Injury; Jugular Bulb; High Performance Liquid Chro;
D O I
10.1007/s11910-003-0057-2
中图分类号
学科分类号
摘要
Patients with cerebral lesions run a high risk of developing cerebral hypoxic and ischemic damage due to secondary insults. To minimize the risk of secondary cerebral hypoxia and ischemia, new monitoring techniques of cerebral oxygenation and metabolism have been developed and may help to understand the pathophysiology of secondary brain damage for a better treatment and outcome in critical patients. Cerebral microdialysis is a relatively new technique for measuring brain molecules of the extracellular space. The technical aspects, the interpretation of the commonly measured parameters, the use of the two commonly used oxygenation parameters (jugular venous oxygen saturation and monitoring of brain tissue PO2 and the microdialysis technique to monitor cerebral metabolism in patients with head injury), subarachnoid hemorrhage, and ischemic stroke are considered. Pitfalls of the techniques and their future potential are discussed. Copyright © 2003 by Current Science Inc.
引用
收藏
页码:517 / 523
页数:6
相关论文
共 49 条
[1]  
Miller J.D., Becker D.P., Secondary insults to the injured brain, J. R. Coll. Surg. Edinburgh, 27, pp. 292-298, (1982)
[2]  
Sheinberg M., Kanter M.J., Robertson C.S., Et al., Continuous monitoring of jugular venous oxygen saturation in head-injured patients, J. Neurosurg., 76, pp. 212-217, (1992)
[3]  
van Santbrink H., Maas A.I., Avezaat C.J., Continuous monitoring of partial pressure of brain tissue oxygen in patients with severe head injury, Neurosurgery, 38, pp. 21-31, (1996)
[4]  
Andrews P.J.D., Dearden N.M., Miller J.D., Jugular bulb cannulation: Description of a cannulation technique and validation of a new continuous monitor, Br. J. Anaesth., 67, pp. 553-558, (1991)
[5]  
Robertson C.S., Narayan R.K., Gokaslan Z.L., Et al., Cerebral arteriovenous oxygen difference as an estimate of cerebral blood flow in comatose patients, J. Neurosurg., 70, pp. 222-230, (1989)
[6]  
Robertson C., Desaturation episodes after severe head injury: Influence on outcome, Acta Neurochir. Suppl. Wien., 59, pp. 98-101, (1993)
[7]  
Stochetti N., Paparelle A., Bridelli F., Et al., Cerebral venous oxygen saturation studied using bilateral samples in the jugular veins, Neurosurgery, 34, pp. 38-44, (1994)
[8]  
Dearden N.M., Midgley S., Technical considerations in continuous jugular venous oxygen saturation measurement, Acta Neurochir. Suppl. (Wien), 59, pp. 91-97, (1993)
[9]  
Jakobsen M., Enevoldsen E., Retrograde catheterization of the right internal jugular vein for serial measurements of cerebral venous oxygen content, J. Cereb. Blood Flow Metab., 9, pp. 717-720, (1989)
[10]  
Kiening K.L., Unterberg A.W., Bardt T.F., Et al., Monitoring of cerebral oxygenation in patients with severe head injuries: Brain tissue PO2 versus jugular vein oxygen saturation, J. Neurosurg., 85, pp. 751-757, (1996)