A lesson learned from jugular venous oximetry.
The authors describe the case of a severely head injured patient whose profound cerebral infarction was clearly indicated by prolonged desaturation on jugular venous oximetry. Shortly thereafter jugular venous oxygen saturation returned to normal stable values and measured within normal limits for the next 24 h. As demonstrated by a computed tomography (CT) scan, these values appear to have represented a jugular mixture of significant amount of cerebral blood that had passed through infarcted tissue and remained highly saturated. This is a very graphic example of the misleading influence that regional flow-metabolic inhomogeneities can have on jugular venous saturation and it emphasizes that cerebral ischemia can be easily missed if no information on cerebral blood flow or regional metabolism is available.
Lang
E W
EW
Department of Neurological Surgery, San Francisco General Hospital, University of California, San Francisco, California, USA.
Chesnut
R M
RM