Application of P(jv-a) CO2 in monitoring cerebral oxygen supply-demand balance in injured brain

摘要

Transcranial Doppler sonography (TCD) assayed cerebral blood flow (CBF) may vary between different intracranial pathologies. Blood gas analysis of the jugular bulb provides a novel way to estimate the global relationship between CBF and oxygen metabolism. In this study, 25 patients with brain trauma, spontaneous intracerebral hemorrhage, and acute cerebral infarction were recruited. Jugular venous oxygen saturation (SjvO(2)) increased significantly at different time points after hyperventilation (p < 0.05). A negative correlation between the partial pressure of CO2 between jugular venous bulb and radial artery blood (P(jv-a)CO2) and CBF could be observed in acute brain injury and spontaneous intracerebral hemorrhage groups, while P(jv-a)CO2 and CBF show positive correlation in acute cerebral infarction group. Our results suggest that serial P(jv-a)CO2 analysis combing with SjvO(2) can be utilized to monitor the change of CBF for patients undergoing craniocerebral surgery. (C) 2019 Published by Elsevier Ltd.