Neurologic outcomes with cerebral oxygen monitoring in traumatic brain injury.
BACKGROUND
Optimizing cerebral oxygenation is advocated to improve outcome in head-injured patients. The purpose of this study was to compare outcomes in brain-injured patients treated with 2 types of monitors.


METHODS
Patients with traumatic brain injury and a Glasgow Coma Scale score<8 were identified on admission. A polarographic cerebral oxygen/pressure monitor (Licox) or fiberoptic intracranial pressure monitor (Camino) was inserted. An evidence-based algorithm for treatment was implemented. Elements from the prehospital and emergency department records and the first 10 days of intensive care unit (ICU) care were collected. Glasgow Outcome Scores (GOS) were determined every 3 months after discharge.


RESULTS
Over a 3-year period, 145 patients were entered into the study; 81 patients in the Licox group and 64 patients in the Camino group. Mortality, hospital length of stay, and ICU length of stay were equivalent in the 2 groups. More patients in the Licox group achieved a moderate/recovered GOS at 3 months than in the Camino Group (79% vs 61%; P = .09).


CONCLUSIONS
Three-month GOS revealed a clinically meaningful 18% benefit in patients undergoing cerebral oxygen monitoring and optimization. Six-month outcomes were also better. Unfortunately, these important differences did not reach significance. Continued study of the benefits of cerebral oxygen monitoring is warranted.
Division of Trauma, Critical Care and Emergency General Surgery, Department of Surgery, Wright State University School of Medicine, Dayton, OH, USA. mary.mccarthy@wright.edu
Mary C
MC
McCarthy
Hugh
H
Moncrief
Jean M
JM
Sands
Ronald J
RJ
Markert
Lawrence C
LC
Hall
Ian C
IC
Wenker
Harry L
HL
Anderson
A Peter
AP
Ekeh
Mbaga S
MS
Walusimbi
Randy J
RJ
Woods
Jonathan M
JM
Saxe
Kathryn M
KM
Tchorz
D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000032:analysis*; D011048:Polarography
D010100:Oxygen