title: Transcranial regional cerebral oxygen desaturation predicts delayed cerebral ischaemia and poor outcomes after subarachnoid haemorrhage: a correlational study.
abstract: OBJECTIVE
  To examine the relationship between regional cerebral oxygen saturation (rSO2), delayed cerebral ischaemia (DCI), and outcomes after aneurysmal subarachnoid haemorrhage (aSAH).
  
  
  METHODS
  Subjects (n = 163) with aSAH, age 21-75 years, and Fisher grade >1 were included in the study. Continuous rSO2 monitoring was performed for 5-10 days after injury using near-infrared spectroscopy with sensors over the frontal/temporal cortex. rSO2<50 indicated desaturation. DCI was defined as neurological deterioration due to impaired cerebral blood flow. Three- and 12-month functional outcomes were assessed by the modified Rankin scale (MRS) as good (0-3) and poor (4-6).
  
  
  RESULTS
  DCI occurred in 57% of patients; of these 66% had rSO2<50. Overall, 56% had rSO2<50 on either side, 21% and 16% had poor MRS at 3 and 12 months. Subjects with rSO2 <50 were 3.25 times more likely to have DCI compared to those with rSO2 >50 (OR 3.25, 95%CI 1.58-6.69), positive predictive value (PPV) = 70%. Subjects with rSO2 <50 were 2.7 times more likely to have poor 3-month MRS compared to those with rSO2 >50 (OR 2.7, 95%CI 1.1-7.2), PPV = 70%.
  
  
  CONCLUSIONS
  These results suggest that NIRS has the potential for detecting DCI after aSAH. This potential needs to be further explored in a larger prospective study.
authors.affiliation: University of Jordan, Faculty of Nursing, Queen Rania Al Abdullah Street, Amman 11942, Jordan. Electronic address: K.yousef@ju.edu.jo.
authors.forename: Khalil M
authors.initials: KM
authors.lastname: Yousef
authors.affiliation: Neurological Surgery Department, University of Pittsburgh Medical Center-Presbyterian, Suite B-400, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Balzer
authors.affiliation: University of Pittsburgh, School of Nursing Acute and Tertiary Care, 320B Victoria Building, 3500 Victoria St., Pittsburgh, PA 15261, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Crago
authors.affiliation: University of Pittsburgh, School of Pharmacy, 807 Salk Hall, Pittsburgh, PA 15213, USA.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Poloyac
authors.affiliation: Acute and Tertiary Care Department, School of Nursing, Department of Neurological Surgery, School of Medicine, University of Pittsburgh, 336 Victoria Building, 3500 Victoria St., Pittsburgh, PA 15261, USA; University of Pittsburgh, School of Nursing Acute and Tertiary Care, 320B Victoria Building, 3500 Victoria St., Pittsburgh, PA 15261, USA.
authors.forename: Paula R
authors.initials: PR
authors.lastname: Sherwood
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000209:etiology* / Q000451:nursing; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications* / Q000175:diagnosis* / Q000451:nursing; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000451:nursing; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cerebral oxygen; Delayed cerebral ischaemia; Subarachnoid Haemorrhage