Correlation between Brain Tissue Oxygen Monitoring Parameters and Transcranial Dopplerometry in Patients with Severe Subarachnoid Hemorrhage

Czech version

Authors: K. Ďuriš ^1,2; E. Neuman ¹; A. Mrlian ¹; V. Vybíhal ¹ ; V. Juráň ¹; M. Kýr ³; M. Smrčka ¹
Authors‘ workplace: Neurochirurgická klinika LF MU a FN Brno ¹; Ústav patologické fyziologie LF MU, Brno ²; Klinika dětské onkologie LF MU a FN Brno ³
Published in: Cesk Slov Neurol N 2014; 77/110(2): 196-201
Category: Original Paper

Práce byla sponzorována grantem IG MZ ČR č. NT 11092- 4.

Overview

Objectives:
The aim of this study was to evaluate correlation between brain tissue oxygen level and transcranial dopplerometry (TCD) parameters in patients with severe subarachnoid hemorrhage (SAH).

Patients and methods:
Patients with subarachnoid hemorrhage from a rupture of cerebral vessel aneurysm and clinical status within the Hunt-Hess scale grade 4 (sopor) or 5 (coma) were enrolled into the study. Brain tissue oxygen monitoring (PbtO₂, Licox system) was performed in addition to the standard ICU monitoring that includes TCD. The correlation between TCD and PbtO₂ parameters was evaluated.

Results:
We enrolled a total of 27 patients, five patients were subsequently excluded for malposition or malfunction of the PbtO₂ probe. There was a significant correlation between PbtO₂ and both pulsatility index and resistivity index in ± 10 minute (PI: r = –0.4077, p = 0.0074; RI: r = –0.4055, p = 0.0077) and ± 60 minute intervals (PI: r = –0.4145, p =0.0064; RI: r = –0.4089, p = 0.007) with a node point corresponding to TCD measurement. There was no significant correlation between PbtO₂ and any of the velocity parameters.

Conclusion:
PbtO₂ monitoring provides information on brain tissue oxygenation and its microvasculature. However, there is no direct link between PbtO₂ values and TCD velocities, the main characteristics of cerebral vasospasm. While we do not know the dynamics between velocities of the main cerebral vessels and PbtO₂, the use of both PbtO₂ monitoring and TCD seems to be appropriate for follow up of patients with severe SAH in clinical setting.

Key words:
subarachnoid hemorrhage – transcranial Doppler sonography – cerebral vasospasm

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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