Clinical Experience with 118 Brain Tissue Oxygen Partial Pressure Catheter Probes
- 1 November 1998
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 43 (5), 1082-1094
- https://doi.org/10.1097/00006123-199811000-00045
Abstract
We assessed the technical and diagnostic reliability of partial pressure of oxygen (PO2) of brain tissue (P(ti)O2) monitoring. The monitoring system and the catheter probes were tested in vitro, and clinical experiences obtained with 118 brain P(ti)O2 catheter probes, used in 101 patients, are reported. The polarographic (LICOX; Medical Systems Corp., Greenvale, NY) P(ti)O2 catheter probe lies 22 to 27 mm below the dura level; its PO2-sensitive surface is 7.1 mm2. For 10 patients, the adaptation time (with initially unreliable signals after insertion) was determined. For 27 patients, the probe was removed in a stepwise fashion (three increments of 5 mm) and the heterogeneity of brain P(ti)O2 levels was investigated. After removal of the catheter probes, their PO2 and zero display error values were determined and compared with probe performance data obtained in vitro with unused PO2 catheter probes. Small iatrogenic hematomas were observed for two patients (1.7%). No infection occurred after 6.7 ± 3.9 days (mean ± standard deviation) of monitoring. The technical complication (dislocation or defect) rate was 13.6%. The mean adaptation time was 79.0 ± 51.7 min. A flow chart is presented, which helps to rule out artifacts. The mean P(ti)O2 measured at 22 to 27 mm below the dura was 23.8 ± 8.1 mm Hg, at 17 to 22 mm was 25.7 ± 8.3 mm Hg, at 12 to 17 mm was 33.0 ± 13.3 mm Hg (P < 0.01, compared with the initial value), and at 7 to 12 mm was 33.3 ± 13.3 mm Hg (P < 0.01). Recent catheter probe versions exhibited a PO2 display error of −1.2 ± 5.1 % (mean ± standard deviation, n = 38) and a mean zero display error of 1.1 ± 0.9 mm Hg (n = 34). The greatest PO2 display errors were measured during the first 4 days of continuous monitoring. In the in vitro test (of 12 unused catheter probes), the maximal probe display error was 1.07 ± 2.14%, tested at temperatures between 22°C and 37°C and tested at oxygen pressures of 0, 44, and 150 mm Hg. In vitro, the zero display error was −0.21 ± 0.25 mm Hg. Brain P(ti)O2 monitoring, reflecting an area 17 to 27 mm below the dura, is a safe and reliable technique for monitoring cerebral oxygenation. Excluding the first 1 hour after insertion, data are reliable, with almost 100% good data quality.Keywords
This publication has 24 references indexed in Scilit:
- The brain parenchyma — PO2 catheter interface, a histopathological study in the ratClinical Neurology and Neurosurgery, 1997
- Brain tissuepO2-monitoring: Catheterstability and complicationsNeurological Research, 1997
- Prospective study of zero drift in fiberoptic pressure monitors used in clinical practiceJournal of Neurosurgery, 1997
- Brain tissue pO2 in relation to cerebral perfusion pressure, TCD findings and TCD-CO2-reactivity after severe head injuryActa Neurochirurgica, 1996
- Ultra-early evaluation of regional cerebral blood flow in severely head-injured patients using xenon-enhanced computerized tomographyJournal of Neurosurgery, 1992
- Cerebral circulation and metabolism after severe traumatic brain injury: the elusive role of ischemiaJournal of Neurosurgery, 1991
- Evaluation of a fiberoptic intracranial pressure monitorJournal of Neurosurgery, 1990
- Effects of increases in the inspired oxygen fraction on brain surface oxygen pressure fields in pig and manActa Anaesthesiologica Scandinavica, 1986
- Microcoaxial Needle Sensor for Polarographic Measurement of Local O2 Pressure in the Cellular Range of Living Tissue. Its Construction and PropertiesPublished by Springer Science and Business Media LLC ,1983
- Quantitative Measurement of Regional Cerebral Blood Flow and Oxygen Metabolism in Man Using 15O and Positron Emission TomographyJournal of Computer Assisted Tomography, 1980