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20-04-2023 | Intracranial Hypertension | Review Article

Monitoring of Brain Tissue Oxygen Tension in Cardiac Arrest: a Translational Systematic Review from Experimental to Clinical Evidence

Authors: Denise Battaglini, Elisa Gouvea Bogossian, Pasquale Anania, Lavienraj Premraj, Sung-Min Cho, Fabio Silvio Taccone, Mypinder Sekhon, Chiara Robba

Published in: Neurocritical Care | Issue 1/2024

Abstract

Background

Cardiac arrest (CA) is a sudden event that is often characterized by hypoxic-ischemic brain injury (HIBI), leading to significant mortality and long-term disability. Brain tissue oxygenation (PbtO₂) is an invasive tool for monitoring brain oxygen tension, but it is not routinely used in patients with CA because of the invasiveness and the absence of high-quality data on its effect on outcome. We conducted a systematic review of experimental and clinical evidence to understand the role of PbtO₂ in monitoring brain oxygenation in HIBI after CA and the effect of targeted PbtO₂ therapy on outcomes.

Methods

The search was conducted using four search engines (PubMed, Scopus, Embase, and Cochrane), using the Boolean operator to combine mesh terms such as PbtO₂, CA, and HIBI.

Results

Among 1,077 records, 22 studies were included (16 experimental studies and six clinical studies). In experimental studies, PbtO₂ was mainly adopted to assess the impact of gas exchanges, drugs, or systemic maneuvers on brain oxygenation. In human studies, PbtO₂ was rarely used to monitor the brain oxygen tension in patients with CA and HIBI. PbtO₂ values had no clear association with patients’ outcomes, but in the experimental studies, brain tissue hypoxia was associated with increased inflammation and neuronal damage.

Conclusions

Further studies are needed to validate the effect and the threshold of PbtO₂ associated with outcome in patients with CA, as well as to understand the physiological mechanisms influencing PbtO₂ induced by gas exchanges, drug administration, and changes in body positioning after CA.

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Title: Monitoring of Brain Tissue Oxygen Tension in Cardiac Arrest: a Translational Systematic Review from Experimental to Clinical Evidence
Authors: Denise Battaglini
Elisa Gouvea Bogossian
Pasquale Anania
Lavienraj Premraj
Sung-Min Cho
Fabio Silvio Taccone
Mypinder Sekhon
Chiara Robba
Publication date: 20-04-2023
Publisher: Springer US
Keywords: Intracranial Hypertension
Cardiopulmonary Resuscitation
Neuromonitoring
Hypoxic-Ischemic Brain Injury
Published in: Neurocritical Care / Issue 1/2024
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-023-01721-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Monitoring of Brain Tissue Oxygen Tension in Cardiac Arrest: a Translational Systematic Review from Experimental to Clinical Evidence

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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Multicenter Comparison of the Safety and Efficacy of Clopidogrel Versus Ticagrelor for Neuroendovascular Stents

Optimal Design of Clinical Trials Involving Persons with Disorders of Consciousness

CSF-Based Volumetric Imaging Biomarkers Highlight Incidence and Risk Factors for Cerebral Edema After Ischemic Stroke

Bundled Treatments in Poor-Grade Subarachnoid Hemorrhage: Do They Help?