Articles: monitoring.
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Neurological research · Jan 1998
Cerebral blood flow and tissue oxygenation monitoring during aneurysm surgery.
Regional cerebral blood flow may be compromised during aneurysm surgery. This may occur during vessel occlusion by temporary clips or result from malposition of the definitive aneurysm clip. Post-operative cerebral vasospasm may also compromise cerebral blood flow and is an important cause of morbidity. ⋯ Initial tissue oxygen levels were low but improved in all cases as the intracranial pressure was reduced. This effect was independent of the cerebral perfusion pressure. Laser Doppler flow provided an indicator of compromised brain function and tissue oxygenation an indicator of established ischemia.
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Acta Neurochir. Suppl. · Jan 1998
Monitoring brain oxygen tension in severe head injury: the Rotterdam experience.
Cerebral ischemia is considered the central mechanism leading to secondary brain damage in patients with severe head injury. We investigated the technique of continuous monitoring of local brain tissue oxygen tension as parameter for cerebral oxygenation. Eighty-two patients with non penetrating severe head injury were studied. ⋯ Early occurrence of values below 10 mm Hg indicated a poor prognosis. Comparative measurements between two catheters performed in six patients showed differences in absolute values measured, but a good correlation of relative changes was observed. We conclude that continuous monitoring of PbrO2 is reliable, clinically applicable and provides the clinician with a better insight in cerebral oxygenation and hopefully should help in targeting therapy towards improved cerebral oxygenation.
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Acta Neurochir. Suppl. · Jan 1998
Monitoring of brain tissue PO2 in traumatic brain injury: effect of cerebral hypoxia on outcome.
This study investigates the effect of hypoxic brain tissue PO2 on outcome, and examines the incidence of possible causes for cerebral hypoxia. We studied 35 patients with severe head injury (GCS < or = 8). Age was 33.2 (+/- 11.3) years. ⋯ Hypocarbia (ETCO2 < 28 mm Hg) was present in 48.0% of the time of PtiO2 < 10 mm Hg. No obvious cause for cerebral hypoxia was found in 45% of the data. These result underscore the association of cerebral hypoxia with poor neurological outcome and stress the meaning of monitoring of PtiO2 as an independent parameter in patients following TBI.
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Acta neurochirurgica · Jan 1998
The Camino intracranial pressure device in clinical practice: reliability, handling characteristics and complications.
Intracranial pressure monitoring has a key role in the management of patients developing increased intracranial pressure (ICP). We adopted the Camino fiberoptic system for intracranial pressure measurement in 1993 in our neurosurgical department. The aim of this study was to investigate reliability, handling characteristics and complication rate of the Camino intracranial pressure device. ⋯ Recorded complications included infection (0.7%), intraparenchymal haematoma (5.1%), and a high complication rate (23.5%) with regard to technical aspects. The Camino intracranial pressure system offers reliable ICP measurements in an acceptable percentage of devices, and the advantage of in vivo recalibration. The high incidence of technical complications identifies a need for improvement in the fiberoptic cable and the fixation system.
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Acta Neurochir. Suppl. · Jan 1998
Comparative StudySimultaneous continuous measurement of pO2, pCO2, pH and temperature in brain tissue and sagittal sinus in a porcine model.
The clinical use of brain tissue oxygen measurement in patients with severe head injury is increasing. It is important to compare the findings in brain tissue with cerebrovenous blood oximetry, to obtain normal values and to find out limitations of the method. We evaluated a newly available multisensor probe simultaneously in the brain tissue and in the sagittal sinus in a porcine animal model. ⋯ Measuring partial oxygen pressure in brain tissue is more responsive to physiological variations, and the absolute values are more sensitive than oxygen measurement in the cerebrovenous compartment. This is important for interpreting measured values and introducing new coefficients for patient monitoring.