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 <55% and 304 (17.6%) with saturation >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.

Arterio-jugular difference of oxygen content and outcome after head injury / N. Stocchetti, K. Canavesi, S. Magnoni, V. Valeriani, V. Conte, S. Rossi, L.G. Longhi, E.R. Zanier, A. Colombo. - In: ANESTHESIA AND ANALGESIA. - ISSN 0003-2999. - 99:1(2004), pp. 230-234. [10.1213/01.ane.0000130393.08355.d4]

Arterio-jugular difference of oxygen content and outcome after head injury

N. Stocchetti
Primo
;
V. Conte;L.G. Longhi;
2004

Abstract

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 <55% and 304 (17.6%) with saturation >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.
Settore MED/41 - Anestesiologia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/143793
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