title: A Prospective Randomized Study of Brain Tissue Oxygen Pressure-Guided Management in Moderate and Severe Traumatic Brain Injury Patients.
abstract: The purpose of this study was to compare the effect of PbtO2-guided therapy with traditional intracranial pressure- (ICP-) guided treatment on the management of cerebral variables, therapeutic interventions, survival rates, and neurological outcomes of moderate and severe traumatic brain injury (TBI) patients. From 2009 to 2010, TBI patients with a Glasgow coma scale <12 were recruited from 6 collaborative hospitals in northern Taiwan, excluding patients with severe systemic injuries, fixed and dilated pupils, and other major diseases. In total, 23 patients were treated with PbtO2-guided management (PbtO2 > 20 mmHg), and 27 patients were treated with ICP-guided therapy (ICP < 20 mmHg and CPP > 60 mmHg) in the neurosurgical intensive care unit (NICU); demographic characteristics were similar across groups. The survival rate in the PbtO2-guided group was also significantly increased at 3 and 6 months after injury. Moreover, there was a significant correlation between the PbtO2 signal and Glasgow outcome scale-extended in patients from 1 to 6 months after injury. This finding demonstrates that therapy directed by PbtO2 monitoring is valuable for the treatment of patients with moderate and severe TBI and that increasing PaO2 to 150 mmHg may be efficacious for preventing cerebral hypoxic events after brain trauma.
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan ; School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chien-Min
authors.initials: CM
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan ; Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ming-Chin
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Department of Surgery, National Taiwan University and Hospital, Taipei, Taiwan.
authors.forename: Sheng-Jean
authors.initials: SJ
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan ; Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
authors.forename: Cheng-Kuei
authors.initials: CK
authors.lastname: Chang
authors.affiliation: Department of Tourism and Leisure Management, China University of Technology, Taipei, Taiwan.
authors.forename: Dan-Ping
authors.initials: DP
authors.lastname: Chao
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
authors.forename: Tai-Ngar
authors.initials: TN
authors.lastname: Lui
authors.affiliation: Department of Neurological surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Hsin-I
authors.initials: HI
authors.lastname: Ma
authors.affiliation: Department of Neurological surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ming-Ying
authors.initials: MY
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wen-Yuh
authors.initials: WY
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yang-Hsin
authors.initials: YH
authors.lastname: Shih
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan ; Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shin-Han
authors.initials: SH
authors.lastname: Tsai
authors.affiliation: School of Public Health, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chiou
authors.affiliation: Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
authors.forename: Mau-Roung
authors.initials: MR
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Sen-Li
authors.initials: SL
authors.lastname: Jen
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Neurosurgery, Taipei Medical University Hospital, Taipei, > Taiwan.
authors.forename: Chung-Che
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Taipei Medical University Hospital, Taipei, > Taiwan.
authors.forename: En-Yuan
authors.initials: EY
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
authors.forename: Kuo-Hsing
authors.initials: KH
authors.lastname: Liao
authors.affiliation: School of Medicine, Taipei Medical University, Taipei, Taiwan ; Department of Neurosurgery, Taipei Medical University Hospital, Taipei, > Taiwan.
authors.forename: Yung-Hsiao
authors.initials: YH
authors.lastname: Chiang
authors.affiliation: Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan ; Department of Health, Executive Yuan, Taipei, > Taiwan.
authors.forename: Wen-Ta
authors.initials: WT
authors.lastname: Chiu
authors.affiliation: Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan ; School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jia-Wei
authors.initials: JW
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000502:physiology*; D001923:Brain Chemistry / Q000502:physiology*; D001930:Brain Injuries / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008875:Middle Aged; D010100:Oxygen / Q000032:analysis*; D011446:Prospective Studies; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D010100:Oxygen