Brain tissue oxygen monitoring in moderate-to-severe traumatic brain injury: Physiological determinants, clinical interventions and current randomised controlled trial evidence

IF 1.4 4区医学 Q3 CRITICAL CARE MEDICINE Critical Care and Resuscitation Pub Date : 2024-09-01 DOI:10.1016/j.ccrj.2024.05.003

Toby Jeffcote FCICM, PhD , Kuan-Ying Lu MBiomedEng , Philip Lewis PhD , Dashiell Gantner FCICM, PhD , Camila R. Battistuzzo PhD , Andrew A. Udy FCICM, PhD

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Abstract

Modern intensive care for moderate-to-severe traumatic brain injury (msTBI) focuses on managing intracranial pressure (ICP) and cerebral perfusion pressure (CPP). This approach lacks robust clinical evidence and often overlooks the impact of hypoxic injuries. Emerging monitoring modalities, particularly those capable of measuring brain tissue oxygen, represent a promising avenue for advanced neuromonitoring. Among these, brain tissue oxygen tension (PbtO₂) shows the most promising results. However, there is still a lack of consensus regarding the interpretation of PbtO₂ in clinical practice. This review aims to provide an overview of the pathophysiological rationales, monitoring technology, physiological determinants, and recent clinical trial evidence for PbtO₂ monitoring in the management of msTBI.

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中重度创伤性脑损伤的脑组织氧监测：生理决定因素、临床干预措施和当前随机对照试验证据

中重度创伤性脑损伤（msTBI）的现代重症监护主要集中在颅内压（ICP）和脑灌注压（CPP）的管理上。这种方法缺乏可靠的临床证据，而且经常忽视缺氧性损伤的影响。新出现的监测模式，尤其是那些能够测量脑组织氧的监测模式，为先进的神经监测带来了希望。其中，脑组织氧张力（PbtO2）显示出最有希望的结果。然而，临床实践中对 PbtO2 的解释仍缺乏共识。本综述旨在概述病理生理学原理、监测技术、生理决定因素，以及在毫秒创伤性脑损伤治疗中进行 PbtO2 监测的最新临床试验证据。

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来源期刊

Critical Care and Resuscitation CRITICAL CARE MEDICINE-

CiteScore

7.70

自引率

3.40%

发文量

审稿时长

>12 weeks

期刊介绍： ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.