Validity and reliability of the SjO2 catheter in neurologically impaired patients: a critical review of the literature.

The purpose of this study was to determine the validity and reliability of the SjO2 catheter in neurologically impaired patients. Cerebral hypoxia and ischemia are two of the most important causes of secondary injury after brain trauma. Early detection and treatment of cerebral ischemia may prevent additional damage to the injured brain. A critical review of literature was conducted by searching the Melvyl database system for the topic of monitor validity and reliability, dating back to 1927. A search of references from current articles also led to more classic studies. Attempts were made to find recent quantitative studies with an emphasis on the incidence of secondary brain ischemia detected by the tool. At best, the SjO2 catheter measures global cerebral oxygenation and is, therefore, unable to detect regional ischemia. In the literature reviewed, nearly 50% of the SjO2 oximetrix catheters provided an unreliable means for monitoring cerebral oxygenation. The initial milestones by Myerson et al. and Gibbs et al. have served as the basis for more refined research on cerebral tissue oxygenation and metabolism. The unreliability of the SjO2 catheter demonstrates how little we still know about cerebral physiology. In spite of the many advancements in healthcare technology, limiting secondary brain injury and improving neurologic outcome have remained elusive.