Vztah mezi parametry transkraniální dopplerometrie a tkáňovou oxymetrií u pacientů s těžkým subarachnoidálním krvácením

Title in English Correlation between Brain Tissue Oxygen Monitoring Parameters and Transcranial Dopplerometry in Patients with Severe Subarachnoid Hemorrhage
Authors

ĎURIŠ Kamil NEUMAN Eduard MRLIAN Andrej VYBÍHAL Václav JURÁŇ Vilém KÝR Michal SMRČKA Martin

Year of publication 2014
Type Article in Periodical
Magazine / Source Česká a Slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Field Neurology, neurosurgery, neurosciences
Keywords subarachnoid hemorrhage; transcranial Doppler sonography; cerebral vasospasm
Description Objectives: The aim of this study was to evaluate correlation between brain tissue oxygen level and transcranial dopplerometry (TCD) parameters in patients with severe subarachnoid hemorrhage (SAH). Patients and methods: Patients with subarachnoid hemorrhage from a rupture of cerebral vessel aneurysm and clinical status within the Hunt-Hess scale grade 4 (sopor) or 5 (coma) were enrolled into the study. Brain tissue oxygen monitoring (PbtO(2), Licox system) was performed in addition to the standard ICU monitoring that includes TCD. The correlation between TCD and PbtO(2) parameters was evaluated. Results: We enrolled a total of 27 patients, five patients were subsequently excluded for malposition or malfunction of the PbtO(2) probe. There was a significant correlation between PbtO(2) and both pulsatility index and resistivity index in +/- 10 minute (PI: r = -0.4077, p = 0.0074; RI: r = -0.4055, p = 0.0077) and +/- 60 minute intervals (PI: r = -0.4145, p =0.0064; RI: r = -0.4089, p = 0.007) with a node point corresponding to TCD measurement. There was no significant correlation between PbtO(2) and any of the velocity parameters. Conclusion: PbtO(2) monitoring provides information on brain tissue oxygenation and its microvasculature. However, there is no direct link between PbtO(2) values and TCD velocities, the main characteristics of cerebral vasospasm. While we do not know the dynamics between velocities of the main cerebral vessels and PbtO(2), the use of both PbtO(2) monitoring and TCD seems to be appropriate for follow up of patients with severe SAH in clinical setting.

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