Current Status of Brain Tissue Oxygen Monitoring in Patients with Traumatic Brain Injury

Abstract

Multiple cerebral monitoring system, an essential facility in neurocritical care units, monitors several vital parameters, including intracranial pressure (ICP), cerebral perfusion pressure (CPP), mean arterial pressure (MAP), partial oxygen pressure of artery(PaO_2), jugular vein oxygen saturation(SjvO_2) and end tidal CO_2 pressure (PetCO_2). In addition to these modalities, brain tissue oxygen monitoring is also essential in understanding the oxygen transport and cerebral metabolism in patients with traumatic brain injury. The brain tissue oxygen monitor is a reliable and effective way to measure oxygen supply and demand along with oxygen saturation in the brain. However, many controversial issues remain unsolved, like the best timing to use the monitor and whether all TBI patients should receive monitoring, regardless of their injury severity. There is also no consensus on the optimal site or the duration of monitoring, and whether it improves the prognosis. The present article attempts to discuss these issues in extensive details. From the perspective of evidence-based medicine, all patients who are at risk of disastrous secondary brain injury following the primary traumatic brain injury, are indicated for brain tissue oxygen monitoring. Multiple cerebral monitoring systems, is not only a safe, robust, and highly sensitive diagnostic tool, but can also lower the overall mortality rates by avoiding cerebral ischemia after traumatic brain injury.