Ngwenya Laura B, Burke John F, Manley Geoffrey T
Department of Neurological Surgery, University of California San Francisco, San Francisco General Hospital, and the Brain and Spinal Injury Center, University of California San Francisco, San Francisco, California 94110.
Respir Care. 2016 Sep;61(9):1232-44. doi: 10.4187/respcare.04962. Epub 2016 Jul 19.
Traumatic brain injury is a problem that affects millions of Americans yearly and for which there is no definitive treatment that improves outcome. Continuous brain tissue oxygen (PbtO2 ) monitoring is a complement to traditional brain monitoring techniques, such as intracranial pressure and cerebral perfusion pressure. PbtO2 monitoring has not yet become a clinical standard of care, due to several unresolved questions. In this review, we discuss the rationale and technology of PbtO2 monitoring. We review the literature, both historic and current, and show that continuous PbtO2 monitoring is feasible and useful in patient management. PbtO2 numbers reflect cerebral blood flow and oxygen diffusion. Thus, continuous monitoring of PbtO2 yields important information about both the brain and the lung. The preclinical and clinical studies demonstrating these findings are discussed. In this review, we demonstrate that patient management in a PbtO2 -directed fashion is not the sole answer to the problem of treating traumatic brain injury but is an important adjunct to the armamentarium of multimodal neuromonitoring.
创伤性脑损伤是一个每年影响数百万美国人的问题，目前尚无能够改善预后的确切治疗方法。持续脑组织氧分压（PbtO2）监测是对传统脑监测技术（如颅内压和脑灌注压）的补充。由于几个尚未解决的问题，PbtO2监测尚未成为临床护理标准。在本综述中，我们讨论了PbtO2监测的基本原理和技术。我们回顾了历史和当前的文献，并表明持续PbtO2监测在患者管理中是可行且有用的。PbtO2数值反映脑血流量和氧扩散。因此，持续监测PbtO2可产生有关脑和肺的重要信息。本文讨论了证明这些发现的临床前和临床研究。在本综述中，我们表明以PbtO2为导向的患者管理并非治疗创伤性脑损伤问题的唯一答案，但它是多模态神经监测手段中的一项重要辅助手段。
