TY - JOUR
T1 - Arterio-jugular difference of oxygen content and outcome after head injury
AU - Stocchetti, Nino
AU - Canavesi, Katia
AU - Magnoni, Sandra
AU - Valeriani, Valerio
AU - Conte, Valeria
AU - Rossi, Sandra
AU - Longhi, Luca
AU - Zanier, Elisa Roncati
AU - Colombo, Angelo
PY - 2004/7
Y1 - 2004/7
N2 - This study investigated AJDo2 (arterio-jugular difference of oxygen content) in a large sample of severely head-injured patients to identify its pattern during the first days after injury and to describe the relationship of AJDo2 with acute neurological severity and with outcome 6 mo after trauma. In 229 comatose head-injured patients, we monitored intracranial pressure, cerebral perfusion pressure, and AJDo2. Outcome was defined 6 mo after injury. Jugular hemoglobin oxygen saturation (Sjo2) averaged 68%. The mean AJDo2 was 4.24 vol% (SD, 1.3 vol%). There were 80 measurements (4.6%) with Sjo2 75%. AJDo2 was higher than 8.7 vol% in 8 measurements (0.4%) and was lower than 3.9 vol% in 718 (42%) measurements. AJDo2 was higher during the first tests and decreased steadily over the next few days. Cases with a favorable outcome had a higher mean AJDo2 (4.3 vol%; SD, 0.3 vol%) than patients with severe disability or vegetative status (3.8 vol%; SD, 1.3 vol%) and patients who died (3.6 vol%; SD, 1 vol%). This difference was significant (P <0.001). We conclude that low levels of AJDo2 are correlated with a poor prognosis, whereas normal or high levels of AJDo2 are predictive of better results.
AB - This study investigated AJDo2 (arterio-jugular difference of oxygen content) in a large sample of severely head-injured patients to identify its pattern during the first days after injury and to describe the relationship of AJDo2 with acute neurological severity and with outcome 6 mo after trauma. In 229 comatose head-injured patients, we monitored intracranial pressure, cerebral perfusion pressure, and AJDo2. Outcome was defined 6 mo after injury. Jugular hemoglobin oxygen saturation (Sjo2) averaged 68%. The mean AJDo2 was 4.24 vol% (SD, 1.3 vol%). There were 80 measurements (4.6%) with Sjo2 75%. AJDo2 was higher than 8.7 vol% in 8 measurements (0.4%) and was lower than 3.9 vol% in 718 (42%) measurements. AJDo2 was higher during the first tests and decreased steadily over the next few days. Cases with a favorable outcome had a higher mean AJDo2 (4.3 vol%; SD, 0.3 vol%) than patients with severe disability or vegetative status (3.8 vol%; SD, 1.3 vol%) and patients who died (3.6 vol%; SD, 1 vol%). This difference was significant (P <0.001). We conclude that low levels of AJDo2 are correlated with a poor prognosis, whereas normal or high levels of AJDo2 are predictive of better results.
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M3 - Article
C2 - 15281535
AN - SCOPUS:3042651598
VL - 99
SP - 230
EP - 234
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 1
ER -