Brain Tissue Oxygenation

How EXACTLY is your doctor ensuring a good supply of oxygen to your brain immediately post stroke? Doing ANYTHING AT ALL?  

• oxygen delivery (27 posts to January 2020) Many ideas in here, if your doctor isn't already using them to save neurons immediately post stroke; you don't have a functioning stroke doctor!

Brain Tissue Oxygenation

• Chapter
• First Online: 01 June 2024

• pp 159–172
• Cite this chapter

Principles and Practice of Neurocritical Care

• Toby Jeffcote &
• Andrew Udy 

• 14 Accesses

Abstract

The brain represents 2% of body weight, but consumes 20% of the body’s oxygen supply as a result of its high metabolic demand. This chapter reviews the physiological determinants of cerebral oxygenation, and the role that ischaemia and hypoxia play in the two pathologies most commonly encountered in the neurocritical care unit - traumatic brain injury (TBI) and sub-arachnoid haemorrhage (SAH). It focuses primarily on the emerging technique of brain tissue oxygen monitoring (PbtO2) which is increasingly used to guide treatment in neurocritical care settings. Despite enormous potential, this method faces significant challenges associated with the complex interplay of systemic and local factors affecting cerebral perfusion and oxygenation. The chapter documents the evolution of PbtO2 monitoring and the evidence for its use. It illustrates how this technique has the potential to enhance clinical management strategies and significantly improve patient outcomes from acute brain injury.

This is a preview of subscription content, log in via an institution to check access.

Brain Tissue Oxygen Monitoring and the Intersection of Brain and Lung: A Comprehensive Review

No clue how feasible this would be at regular hospitals and what the hell good such monitoring does. What interventions could occur based on this knowledge? We'll never know since there is NO one in the whole world we can ask such fuckingly simple questions of.

Brain Tissue Oxygen Monitoring and the Intersection of Brain and Lung: A Comprehensive Review

1. Laura B Ngwenya, MD PhD,
2. John F Burke, MD PhD and
3. Geoffrey T Manley, MD PhD⇑

+ Author Affiliations

1. Department of Neurological Surgery, University of California San Francisco, San Francisco General Hospital, and the Brain and Spinal Injury Center, University of California San Francisco, San Francisco, California 94110.

Abstract

Traumatic brain injury is a problem that affects millions of Americans yearly and for which there is no definitive treatment that improves outcome. Continuous brain tissue oxygen (P_btO2) monitoring is a complement to traditional brain monitoring techniques, such as intracranial pressure and cerebral perfusion pressure. P_btO2 monitoring has not yet become a clinical standard of care, due to several unresolved questions. In this review, we discuss the rationale and technology of P_btO2 monitoring. We review the literature, both historic and current, and show that continuous P_btO2 monitoring is feasible and useful in patient management. P_btO2 numbers reflect cerebral blood flow and oxygen diffusion. Thus, continuous monitoring of P_btO2 yields important information about both the brain and the lung. The preclinical and clinical studies demonstrating these findings are discussed. In this review, we demonstrate that patient management in a P_btO2-directed fashion is not the sole answer to the problem of treating traumatic brain injury but is an important adjunct to the armamentarium of multimodal neuromonitoring.