Avoiding brain hypoxia in severe traumatic brain injury in settings with limited resources - A pathophysiological guide

Copyright © 2023 Elsevier Inc. All rights reserved..

Cerebral oxygenation represents the balance between oxygen delivery, consumption and utilization by the brain, and therefore reflects the adequacy of cerebral perfusion. Different factors can influence the amount of oxygen to the brain including arterial blood pressure, hemoglobin levels, systemic oxygenation, and transfer of oxygen from blood to the cerebral microcirculation. A mismatch between cerebral oxygen supply and demand results in cerebral hypoxia/ischemia, and is associated with secondary brain damage and worsened outcome after acute brain injury. Therefore, monitoring and prompt treatment of cerebral oxygenation compromise is warranted in both neuro and general intensive care unit populations. Several tools have been proposed for the assessment of cerebral oxygenation, including non-invasive/invasive or indirect/direct methods, including Jugular Venous Oxygen Saturation (SjO2), Partial Brain Tissue Oxygen Tension (PtiO2), Near infrared spectroscopy (NIRS), Transcranial Doppler, electroencephalography and Computed Tomography. In this manuscript, we aim to review the pathophysiology of cerebral oxygenation, describe monitoring technics, and generate recommendations for avoiding brain hypoxia in settings with low availability of resources for direct brain oxygen monitoring.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:75

Enthalten in:

Journal of critical care - 75(2023) vom: 01. Juni, Seite 154260

Sprache:

Englisch

Beteiligte Personen:

Godoy, Daniel Agustin [VerfasserIn]
Rubiano, Andres M [VerfasserIn]
Paranhos, Jorge [VerfasserIn]
Robba, Chiara [VerfasserIn]
Lazaridis, Christos [VerfasserIn]

Links:

Volltext

Themen:

Brain hypoxia
Brain oxygenation
Cerebral ischemia
Cerebral oxygenation monitoring
Journal Article
Limited resources setting
Oxygen
Review
S88TT14065
Traumatic brain injury

Anmerkungen:

Date Completed 24.04.2023

Date Revised 28.05.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jcrc.2023.154260

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM352830670