title: Brain tissue oxygen guided treatment supplementing ICP/CPP therapy after traumatic brain injury.
abstract: OBJECTIVE
  To evaluate the effects of a brain tissue oxygen (P(ti)O(2)) guided treatment in patients with traumatic brain injury.
  
  
  METHODS
  P(ti)O(2) was monitored in 93 patients with severe traumatic brain injury. Forty patients admitted from 1993 to 1996 were treated with intracranial pressure/cerebral perfusion pressure (ICP/CPP) management alone (ICP < 20 mm Hg, CPP > 70 mm Hg). Fifty three patients admitted from 1997 to 2000 were treated using ICP/CPP management, but in this second group CPP was also increased as individually required to raise the P(ti)O(2) above 1.33 kPa (10 mm Hg) (P(ti)O(2) guided group).
  
  
  RESULTS
  Cerebral hypoxic phases with P(ti)O(2) values below 1.33 kPa occurred significantly less often in the P(ti)O(2) guided group. P(ti)O(2) values were higher over the whole monitoring period. No statistical differences could be observed in outcome at six months, despite a positive trend in the P(ti)O(2) guided group.
  
  
  CONCLUSIONS
  Cerebral hypoxic events can be reduced significantly by increasing cerebral perfusion pressure as required. To show a clear beneficial effect of P(ti)O(2) guided cerebral perfusion pressure management on outcome, a multicentre randomised trial needs to be undertaken.
authors.affiliation: Klinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig, Germany. meix.medizin@uni-leipzig.de
authors.forename: J
authors.initials: J
authors.lastname: Meixensberger
authors.forename: M
authors.initials: M
authors.lastname: Jaeger
authors.forename: A
authors.initials: A
authors.lastname: Väth
authors.forename: J
authors.initials: J
authors.lastname: Dings
authors.forename: E
authors.initials: E
authors.lastname: Kunze
authors.forename: K
authors.initials: K
authors.lastname: Roosen
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D046508:Culture Techniques; D015600:Glasgow Coma Scale; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D007427:Intracranial Pressure / Q000502:physiology*; D010100:Oxygen / Q000378:metabolism* / Q000627:therapeutic use*; D011312:Pressure
chemical_list: D010100:Oxygen