Relationship of brain tissue Po2 to outcome after severe head injury
Relationship of brain tissue Po2 to outcome after severe head injury
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DOI：
10.1097/00003246-199809000-00029
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发表时间：
1998-09-01
影响因子：
8.8
通讯作者：
Robertson, CS
中科院分区：
文献类型：
--
作者：
Valadka, AB;Gopinath, SP;Robertson, CS
目的：确定重型颅脑损伤后脑组织Po-2阈值（PbtO(2)）。设计：前瞻性数据收集。环境：本陶布总医院神经外科重症监护室，综合性学术神经外科设施和一级创伤中心。患者：43例重型颅脑损伤患者在就诊时不服从命令或入院后病情恶化至此水平。干预措施：在开颅术或重症监护病房时，在脑内放置Licox （n = 39）或Paratrend (n = 4) Po-2探针。测量和主要结果：Pbto(2)监测持续平均84.6±41.8小时。探针在插入前根据制造商的规格进行校准。取下探针后，在室内空气和血气标准校准溶液中进行测试。对Pbto(2)数据进行分析，比较伤后存活3个月的患者与死亡患者Pbto(2)低于20、15、10、8、6、4和2吨（分别为2.7、2.0、1.3、1.0、0.8、0.5和0.3 kPa）的平均时间。采用最大似然法进行Tobit回归分析。Licox和Paratrend探针在室内空气和一级控制中都表现良好。然而，在零氧溶液中，parattrend探针的平均读数为7.0 +/- 1.4 torr (0.9 +/- 0.2 kPa)，而Licox探针的平均读数为0.3 +/- 0.3 torr （0.04 +/- 0.04 kPa）。结论：对PbtO(2)监测数据的分析表明，随着PbtO(2)在15 torr （2.0 kPa）或低于15 torr （2.0 kPa）或出现任何PbtO(2)值小于或等于6 torr（小于或等于0.8 kPa）时持续时间的增加，死亡的可能性增加。
Objective: To determine thresholds of brain tissue Po-2 (PbtO(2)) that are critical for survival after severe head injury.Design: Prospective data collection.Setting: Neurosurgical intensive care unit of Ben Taub General Hospital, a comprehensive academic neurosurgical facility and Level I trauma center.Patients: Forty-three severely head-injured patients who were not obeying commands on presentation or whose condition deteriorated to this level shortly after admission.Interventions: Intracerebral placement of Licox (n = 39) or Paratrend (n = 4) Po-2 probes during craniotomy or in the intensive care unit.Measurements and Main Results: Pbto(2) monitoring continued for an average of 84.6 +/- 41.8 hrs. The probes were calibrated before insertion according to the manufacturer's specifications. After removal, probes were tested in room air and in blood gas standard calibration solutions. Pbto(2) data were analyzed by comparing the average time that Pbto(2) was below the values of 20, 15, 10, 8, 6, 4, and 2 ton (2.7, 2.0, 1.3, 1.0, 0.8, 0.5, and 0.3 kPa, respectively) in patients who were living 3 mos after injury vs. those who died. A Tobit regression analysis using maximum likelihood methods was utilized.Both Licox and Paratrend probes functioned well in room air and in the Level I control. However, in the zero-oxygen solution, the Paratrend probes gave an average reading of 7.0 +/- 1.4 torr (0.9 +/- 0.2 kPa), compared with 0.3 +/- 0.3 torr (0.04 +/- 0.04 kPa) for the Licox probes.Conclusions: Analysis of the PbtO(2) monitoring data suggested that the likelihood of death increased with increasing duration of time at or below a Pbto(2) of 15 torr (2.0 kPa) or with the occurrence of any Pbto(2) values of less than or equal to 6 torr (less than or equal to 0.8 kPa).