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Relationship between early patterns of cerebral extraction of oxygen and outcome from severe acute traumatic brain swelling: Cerebral ischemia or cerebral viability?
Journal article   Peer reviewed

Relationship between early patterns of cerebral extraction of oxygen and outcome from severe acute traumatic brain swelling: Cerebral ischemia or cerebral viability?

Julio Cruz and Janet Cruz
Critical care medicine, v 24(6), pp 953-956
Jun 1996
PMID: 8681597

Abstract

OBJECTIVE To evaluate outcome from severe acute traumatic diffuse brain swelling, in relation to early patterns of global cerebral extraction of oxygen. DESIGN Prospective, interventional study. SETTING Neuroscience intensive care unit of a university hospital. PATIENTS Adults (n equals 205) with acute, essentially isolated brain trauma (predominantly diffuse brain swelling), undergoing routine early monitoring of cerebral extraction of oxygen and intracranial pressure, along with other monitoring modalities. INTERVENTIONS Routine neuroemergency procedures. MEASUREMENTS AND MAIN RESULTS Cerebral extraction of oxygen (arteriojugular oxyhemoglobin saturation difference) was measured in each patient, early in the acute phase (2 to 8 hrs postinjury). Outcome at 6 months postinjury was significantly better in patients with initially increased cerebral extraction of oxygen (more than 42%) than in those patients with normal (24% to 42%) or decreased (less than 24%) values. In contrast, no significant differences were found among these three groups with respect to age, initial Glasgow Coma Scale score, intracranial pressure, cerebral perfusion pressure, Paco2, total hemoglobin content, and time from injury when the initial measurements were performed. CONCLUSIONS Initially increased cerebral extraction of oxygen appears to indicate global cerebral viability rather than cerebral ischemia in patients with acute traumatic diffuse brain swelling.(Crit Care Med 1996; 24:953-956)

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