This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by White, H. Articles by Baker, A. Search for Related Content PubMed PubMed Citation Articles by White, H. Articles by Baker, A.

Continuous jugular venous oximetry in the neurointensive care unit – a brief review

[L'oxymétrie continue de la veine jugulaire à l'unité des soins intensifs neurologiques – une brève revue]

From the Trauma and Neurosurgery Intensive Care Unit, Department of Anaesthesia, St Michael's Hospital, Toronto, Ontario, Canada.

Address correspondence to: Dr. Andrew Baker, Department of Anaesthesia, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. Phone: 416-864-5510; Fax: 416-864-5512; E-mail: bakera{at}smh.toronto.on.ca

Purpose: To describe the technique of continuous jugular venous oxygen saturation (SjVO₂) monitoring and review its applications in the neurointensive care unit (NICU), with special reference to the management of raised intracranial pressure (ICP) following severe acute brain injury.

Source: This narrative review is based on a selection of current literature on SjVO₂ monitoring in conjunction with local experience using this technique.

Principal findings: Despite limitations, the use of SjVO₂ monitoring has the potential to impact on patient care in the NICU. The placement of the catheter is relatively simple. Studies have confirmed that abnormalities in cerebral venous oxygen saturation are associated with adverse outcome following traumatic brain injury. There is evidence that SjVO₂ may be a useful adjunct to ICP monitoring of patients with intracranial hypertension. Furthermore, managing cerebral extraction of oxygen in conjunction with cerebral perfusion pressure may result in an improved outcome. Further research in this area is needed. Other indications for SjVO₂ monitoring include subarachnoid hemorrhage, cardiopulmonary bypass and following ischemic stroke.

Conclusion: In the past, the management of severe acute brain injury was targeted at ICP and perfusion pressure with little consideration for the metabolic requirements of the injured brain. SjVO₂ monitoring is another tool the intensivist can use to obtain information about the global oxygen requirements of the injured brain on a continuous basis. Whether this will impact on care in the long term remains to be seen.

This article has been cited by other articles:

				K. Pattinson, G. Wynne-Jones, and C. H. Imray Monitoring intracranial pressure, perfusion and metabolism CEACCP, August 1, 2005; 5(4): 130 - 133. [Abstract] [Full Text] [PDF]

				S. Inoue, M. Kawaguchi, H. Furuya, and T. Sakaki Antecubital approach for monitoring jugular bulb venous oxygen saturation during carotid endarterectomy Can J Anesth, June 1, 2005; 52(6): 656 - 657. [Full Text] [PDF]

				A. D. McLeod, F. Igielman, C. Elwell, M. Cope, and M. Smith Measuring Cerebral Oxygenation During Normobaric Hyperoxia: A Comparison of Tissue Microprobes, Near-Infrared Spectroscopy, and Jugular Venous Oximetry in Head Injury Anesth. Analg., September 1, 2003; 97(3): 851 - 856. [Abstract] [Full Text] [PDF]