The current literature reports many measurements (arteriovenous oxygen content difference and cerebral metabolic rate of oxygen, etc.) with samples from the internal jugular veins (IJs), obtained from either side of the neck, based on the assumption that a reliable sample of mixed venous blood can be drawn. We compared oxygen saturation in both IJs in 32 patients with head injuries to establish the similarities or discrepancies in the two veins. Both IJs were cannulated with 20-G catheters; in five patients, a fiberoptic catheter was used to obtain a continuous recording of the hemoglobin saturation. Blood samples were taken simultaneously from the two IJs and immediately processed; the total number of samples processed was 342, with an average of 5.34 paired samples from each patient. The mean and the standard deviation of the differences between the saturation of the two IJs were, respectively, 5.32 and 5.15. Fifteen patients showed differences greater than 15% in hemoglobin saturation; three more patients showed differences greater than 10% at some point during the investigation. Ultimately, only eight patients had differences of less than 5%. No relationship was found among the computed tomographic scan data and the pattern of hemoglobin saturation detected. Therefore, we were not able to identify the side more appropriate for monitoring in patients with bilateral, predominantly monolateral, cortical, or deeply located lesions.The 95% confidence limits for the percentage of patients with a difference higher than 15% were between 30 and 64%; the limits for the percentage of patients with a difference higher than 10 were between 39 and 73%; ultimately, the limits for the percentage of patients with a difference higher than 5 were between 60 and 90%. The proportion of patients with relevant discrepancies between the two IJs is higher than suspected, and the reliability of a single item of data obtained from a single IJ is questionable.
|Titolo:||Cerebral venous oxygen saturation studied with bilateral samples in the internal jugular veins|
STOCCHETTI, NINO (Primo)
|Parole Chiave:||Adult ; Brain ; Brain Concussion ; Brain Injuries ; Carbon Dioxide ; Dominance, Cerebral ; Female ; Hematoma, Epidural, Cranial ; Hematoma, Subdural ; Hemoglobinometry ; Humans ; Intracranial Pressure ; Jugular Veins ; Male ; Middle Aged ; Oxygen ; Tomography, X-Ray Computed ; Blood Specimen Collection|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
|Data di pubblicazione:||gen-1994|
|Appare nelle tipologie:||01 - Articolo su periodico|