Cerebral oxygen metabolism monitoring under hypothermia for severe subarachnoid hemorrhage: report of eight cases.

OBJECTIVES

The significance of cerebral oxygen metabolism monitoring under hypothermia for severe subarachnoid hemorrhage (SAH) was studied.

MATERIAL AND METHODS

Cerebral oxygen metabolism monitoring (jugular venous oxygen saturation: SjO2, arterio-jugular venous difference of oxygen: AJDO2, and oxygen extraction fraction:OEF) during hypothermia (32-34 degrees C) was evaluated in eight patients with SAH (severe vasoapasm group: five patients, and severe brain damage group: three patients).

RESULTS

In favorable cases in both groups, each parameter tended to normalize during hypothermia therapy. When changes in SjO2 were normal, however, the value of AJDO2 was low in unfavorable cases in the severe vasospasm group. In unfavorable cases in the severe brain damage group, high level of SjO2 and low level of OEF and AJDO2 were shown even if hypothermia therapy was performed.

CONCLUSIONS

The measurement of SjO2 and AJDO2 is useful for estimation of cerebral oxygen metabolism in patients with severe conscious disturbance after SAH under hypothermia therapy.