Menzel M, Rieger A, Roth S, Soukup J, Furka I, Miko I, Molnar P, Peuse C, Hennig C, Radke J
Anaesthesiology, University of Halle, Germany.
J Neurotrauma. 1998 Apr;15(4):265-76. doi: 10.1089/neu.1998.15.265.
Local brain tissue oxygenation (p(ti)O2) and global cerebrovenous hemoglobin saturation (SjO2) are increasingly used to continuously monitor patients after severe head injury (SHI). In patients, simultaneous local and global oxygen measurements of these types have shown different results regarding the comparability of the findings during changes in CPP and ICP. This is in contrast to theoretical expectations. The aim of this study was to compare p(ti)O2 measurement with cerebrovenous oxygen partial pressure measurement (p(cv)O2) in an animal intracranial pressure model. To this end, a multisensor probe was placed in the left frontoparietal white matter to measure p(ti)O2, pCO2 (p(ti)CO2), pH (pH[ti]), and temperature (t[ti]) while simultaneously measuring these same parameters (p(cv)O2, p(cv)CO2 pH(cv), t[cv]) in the sagittal sinus of 9 pigs under general anesthesia. By stepwise inflating a balloon catheter, placed in supracerebellar infratentorial compartment, ICP was increased and CPP was decreased. The baseline levels of p(ti)O2, p(ti)CO2, and pH(ti) in the noninjured brain tissue showed more heterogeneity compared to the findings in cerebrovenous blood. Both, p(ti)O2 and p(cv)O2 were significantly correlated to the induced CPP decrease. PCO2 was inversely correlated to the course of CPP in both measurement compartments. Temperature measurement showed a positive correlation with CPP in both compartments. These findings demonstrate that brain tissue oximetry and cerebrovenous PO2 measurement are sensitive to CPP changes. The newly available continuous parameters in multisensor probes could be helpful in interpreting findings of cerebral oxygen measurement in man by analyzing the interrelationship of these parameters.
局部脑组织氧合(p(ti)O2)和全脑静脉血红蛋白饱和度(SjO2)越来越多地用于重型颅脑损伤(SHI)患者的连续监测。在患者中,同时进行的这类局部和全局氧测量在脑灌注压(CPP)和颅内压(ICP)变化期间的结果可比性方面显示出不同的结果。这与理论预期相反。本研究的目的是在动物颅内压模型中比较p(ti)O2测量与脑静脉血氧分压测量(p(cv)O2)。为此,将一个多传感器探头置于左侧额顶叶白质中,以测量p(ti)O2、pCO2(p(ti)CO2)、pH(pH[ti])和温度(t[ti]),同时在9头全麻猪的矢状窦中测量相同参数(p(cv)O2、p(cv)CO2、pH(cv)、t[cv])。通过逐步向置于小脑上幕下腔的球囊导管充气,增加ICP并降低CPP。与脑静脉血中的结果相比,未受伤脑组织中的p(ti)O2、p(ti)CO2和pH(ti)的基线水平显示出更多的异质性。p(ti)O2和p(cv)O2均与诱导的CPP降低显著相关。在两个测量腔室中,PCO2与CPP的变化过程呈负相关。温度测量在两个腔室中均与CPP呈正相关。这些发现表明,脑组织血氧测定和脑静脉PO2测量对CPP变化敏感。多传感器探头中新可用的连续参数可能有助于通过分析这些参数之间的相互关系来解释人体脑氧测量的结果。