Cerebral Oxygenation Non Invasive Monitoring in Traumatic Brain Injury - A Pilot Study

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Introduction. Cerebral oxymetry obtained with Near Infrared Spectroscopy (NIRS) provides noninvasive monitoring of microvasculature in the brain allowing for early recognition and preventive treatment of impaired cerebral oxygenation in traumatic brain injuries. Optimizing cerebral oxygenation is advocated to improve outcome in traumatic brain injured (TBI) hence the goal of this study was to determine the benefit of non invasive monitoring of cerebral oxygenation.

Methods. Noninvasive monitoring was conducted in fifteen patients with traumatic brain injury. The values and changes in cerebral oxymetry were analyzed and compared with others tracked parameters: Glasgow Coma Scale on admission to determine the severity of traumatic brain injuries, systolic arterial blood pressure, mean arterial blood pressure, pulse oxymetry, and regular laboratory test. Regional cerebral oxygenation was measured using cerebral oxymetar INVOS 5100 Somanetics®.

Results. According to obtained data, we noticed that any change in hemodynamic profile directly influenced the regional cerebral oxygen saturation. Higher changes in values of 15 % and more from basal ones correlate with unfavorable outcome as neurologic sequels. Decreased values of rSO2 in our study were rectified with several simple interventions. In our cases parameter which was most prominent cause for disturbed rSO2 was decreased mean arterial blood pressure.

Conclusion. Stable hemodynamic profile leads to optimized cerebral oxygenation. Monitoring the regional oxygen saturation influenced by several factors is important step for forehanded detection of adverse secondary brain injuries. NIRS technology as monitoring system has potential to have diagnostic value and enable right therapeutic decisions and consequently better prognosis in TBI. Continued study of the benefits of cerebral oxygen monitoring is warranted.

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