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Neurocritical Care
Published in: Neurocritical Care 2/2014

01-12-2014 | Review Article

Monitoring of Brain and Systemic Oxygenation in Neurocritical Care Patients

Authors: Mauro Oddo, Julian Bösel, and the Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring

Published in: Neurocritical Care | Special Issue 2/2014

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Abstract

Maintenance of adequate oxygenation is a mainstay of intensive care, however, recommendations on the safety, accuracy, and the potential clinical utility of invasive and non-invasive tools to monitor brain and systemic oxygenation in neurocritical care are lacking. A literature search was conducted for English language articles describing bedside brain and systemic oxygen monitoring in neurocritical care patients from 1980 to August 2013. Imaging techniques e.g., PET are not considered. A total of 281 studies were included, the majority described patients with traumatic brain injury (TBI). All tools for oxygen monitoring are safe. Parenchymal brain oxygen (PbtO2) monitoring is accurate to detect brain hypoxia, and it is recommended to titrate individual targets of cerebral perfusion pressure (CPP), ventilator parameters (PaCO2, PaO2), and transfusion, and to manage intracranial hypertension, in combination with ICP monitoring. SjvO2 is less accurate than PbtO2. Given limited data, NIRS is not recommended at present for adult patients who require neurocritical care. Systemic monitoring of oxygen (PaO2, SaO2, SpO2) and CO2 (PaCO2, end-tidal CO2) is recommended in patients who require neurocritical care.
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Metadata
Title
Monitoring of Brain and Systemic Oxygenation in Neurocritical Care Patients
Authors
Mauro Oddo
Julian Bösel
and the Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring
Publication date
01-12-2014
Publisher
Springer US
Published in
Neurocritical Care / Issue Special Issue 2/2014
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-014-0024-6

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Monitoring of Cerebral Blood Flow and Ischemia in the Critically Ill

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Consensus Summary Statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care

Appendix

The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: Evidentiary Tables

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Multimodality Monitoring: Informatics, Integration Data Display and Analysis

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Monitoring Inflammation (Including Fever) in Acute Brain Injury