title: Incidence of intracranial hypertension related to jugular bulb oxygen saturation disturbances in severe traumatic brain injury patients.
abstract: OBJECTIVE
  To analyze the Intracranial Hypertension (IH) development related to jugular bulb oxygen saturation (SjO2) disturbances in severe traumatic brain injury patients (sTBI).
  
  
  METHODS
  One hundred and thirty-five sTBI patients were reviewed. Those without IH at admission (n = 116) were included. All patients underwent ICP and SjO2 continuous monitoring. Two groups were distinguished according to the SjO2 values during the first 24 hours. Group A: those with abnormal SjO2 (SjO2 more than 75% or less than 55%) and Group B: those with normal SjO2 (55-75%). Differences in IH development and outcome between groups were analyzed. Causes of abnormally low SjO2 were identified.
  
  
  RESULTS
  IH developed in 56.9% of patients, between 12 and 48 hours from admission. Group A had a significantly higher incidence of IH than Group B (p < 0.001) and it also had a worse outcome than Group B (GOS 1-2) (p < 0.005). Patients from Group A had a risk of IH 4.5 fold higher than Group B. Considering only patients who developed IH, an abnormal SjO2 value increased 2.3 fold the risk of death compared to those without SjO2 disturbances. Main causes of SjO2 desaturation were hyperventilation (40.7%), hypovolemia (28.4%) and anemia (21%).
  
  
  CONCLUSIONS
  Early detection of disturbances in oxygen supply-demand relationship and prevention or resolution of the secondary insults which produce these disturbances, might lead to a reduction in the incidence of intracranial hypertension.
authors.affiliation: Prof. Dr. Luis Güemes General Hospital, Haedo, Buenos Aires, Argentina.
authors.forename: P
authors.initials: P
authors.lastname: Schoon
authors.forename: L
authors.initials: L
authors.lastname: Benito Mori
authors.forename: G
authors.initials: G
authors.lastname: Orlandi
authors.forename: C
authors.initials: C
authors.lastname: Larralde
authors.forename: M
authors.initials: M
authors.lastname: Radrizzani
mesh_terms: D001930:Brain Injuries / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D019586:Intracranial Hypertension / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D007427:Intracranial Pressure; D007601:Jugular Veins; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000097:blood*; D012151:Resuscitation; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D010100:Oxygen