Evaluation of a Novel Brain Tissue Oxygenation Probe in an Experimental Swine Model
- 1 December 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 67 (6), 1716-1723
- https://doi.org/10.1227/neu.0b013e3181f9bb5b
Abstract
Cerebral microdialysis, cerebral blood flow, and cerebral oxygenation (PbrO2) measurements using intraparenchymal probes are widely accepted as invasive diagnostic monitoring for early detection of secondary ischemia. To evaluate a novel PbrO2 probe for continuous and quantitative oxygenation assessment compared with the existing gold standard PbrO2 probe. In 9 pigs, 2 PbrO2 probes (Neurovent-TO vs Licox) were implanted into the subcortical white matter. An intracranial pressure probe was inserted contralaterally. The PbrO2 probes were tested during (1) baseline measurements followed by (2) hyperoxygenation (fraction of inspired oxygen [Fio2] = 1.0), medically induced (3) hypo- and (4) hypertension, (5) hyperventilation, (6) tris-hydroxymethylaminomethane application, and (7) hypoxygenation (Fio2 < 0.05). For statistical analyses, Bland-Altman plots were used. The Neurovent-TO probe is easy to handle and does not need a specific storage or calibration. Bland-Altman analyses revealed good comparability of both technologies under baseline conditions (meandiff 2.09 mm Hg, standard deviation 0.04 mm Hg, range 1.98-2.20 mm Hg), but measurement dynamics during hyperoxygenation (Fio2 = 1.0) revealed significantly different profiles, eg Neurovent-TO probe reached up to 1.53-fold higher PbrO2 values than the Licox probe. During hypoxygenation (Fio2 < 0.05), the Neurovent-TO probe detected the hypoxic level of 8.5 mm Hg 1.5 minutes earlier than did the Licox probe. All other maneuvers showed similar responses in both technologies. The Neurovent-TO PbrO2 device comparably measures PbrO2 under most conditions tested compared with the Licox device. The Neurovent-TO is more sensitive to rapid Fio2 changes. Further studies are necessary to clarify these differences. It is questionable whether existing knowledge of Licox tissue oxygenation, ie, hypoxic threshold, can be directly transferred to the Neurovent-TO.Keywords
This publication has 18 references indexed in Scilit:
- Brain oxygen tension and outcome in patients with aneurysmal subarachnoid hemorrhageJournal of Neurosurgery, 2008
- Continuous Monitoring of Cerebrovascular Autoregulation After Subarachnoid Hemorrhage by Brain Tissue Oxygen Pressure Reactivity and Its Relation to Delayed Cerebral InfarctionStroke, 2007
- Temporal changes in cerebral tissue oxygenation with cerebrovascular pressure reactivity in severe traumatic brain injuryJournal of Neurology, Neurosurgery & Psychiatry, 2006
- Continuous assessment of cerebrovascular autoregulation after traumatic brain injury using brain tissue oxygen pressure reactivity*Critical Care Medicine, 2006
- Brain tissue oxygen (PtiO2): a clinical comparison of two monitoring devicesPublished by Springer Science and Business Media LLC ,2005
- Normobaric hyperoxia—induced improvement in cerebral metabolism and reduction in intracranial pressure in patients with severe head injury: a prospective historical cohort—matched studyJournal of Neurosurgery, 2004
- Brain tissue oxygen guided treatment supplementing ICP/CPP therapy after traumatic brain injuryJournal of Neurology, Neurosurgery & Psychiatry, 2003
- Continuous monitoring of regional cerebral blood flow: experimental and clinical validation of a novel thermal diffusion microprobeJournal of Neurosurgery, 2000
- Clinical Experience with 118 Brain Tissue Oxygen Partial Pressure Catheter ProbesNeurosurgery, 1998
- STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENTThe Lancet, 1986