naa a22 4500 510799914 CHVBK 20180411083350.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s12028-012-9797-7 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9797-7 Goal Directed Brain Tissue Oxygen Monitoring Versus Conventional Management in Traumatic Brain Injury: An Analysis of In Hospital Recovery [Elektronische Daten] [Joel Green, Daniela Pellegrini, Wayne Vanderkolk, Bryan Figueroa, Evert Eriksson] Background: Brain tissue oxygen monitoring (pBtO2) has been advocated in the treatment of patients with severe traumatic brain injuries (TBI); however, controversy exists regarding the improvements that pBtO2 monitoring provides. The objective of our study was to evaluate our experience and effect on mortality with goal directed pBtO2 monitoring for severe TBI compared to traditional ICP/CPP monitoring. Methods: All patients admitted with severe TBI (GCS<8) to our Level 1 trauma center from June 2007 through June 2009 were retrospectively analyzed. All patients had ICP monitoring and pBtO2 monitors were placed based on the current practices of the attending neurosurgeon producing two temporally matched cohorts of patients with and without pBtO2 monitors. Exclusion criteria were age <18years and survival <24h. Goal-directed therapy was utilized in all patients to maintain ICP <20mmHg and CPP >60mmHg. Patients with pBtO2 monitors were managed to maintain a level >20mmHg. Results: 74 patients were treated for severe TBI over the 2-year study period with 37 patients in each group. Both groups were similar in age, sex, and admission Glascow Coma Score(GCS).The pBtO2-monitored group did, however, have significantly lower injury severity score [26 (25-30) vs. 30 (26-36), p=0.03] and AIS Chest [0 (0-0) vs. 2 (0-3), p=0.02]. There was no survival difference found (64.9 vs. 54.1%, p=0.34). No difference with respect to discharge GCS or discharge Functional Independence Measure score was identified. Conclusions: Compared with ICP/CPP-directed therapy alone, the addition of pBtO2 monitoring did not provide a survival or functional status improvement at discharge. The true clinical benefit of pBtO2 monitoring will require further study. Springer Science+Business Media New York, 2012 Trauma nationallicence pBtO2 nationallicence Traumatic brain injury nationallicence Brain tissue oxygenation nationallicence Intracranial pressure nationallicence Intracranial monitor nationallicence Outcome nationallicence Green Joel Department of Trauma, Saint Mary's Health Care, Grand Rapids, MI, USA aut Pellegrini Daniela Department of Internal Medicine, University of Wisconsin-Madison, Madison, WI, USA aut Vanderkolk Wayne Department of Trauma, Saint Mary's Health Care, Grand Rapids, MI, USA aut Figueroa Bryan Department of Neurosurgery, Spectrum Health, Grand Rapids, MI, USA aut Eriksson Evert Department of General Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 420, 29425, Charleston, SC, USA aut Neurocritical Care Humana Press Inc 18/1(2013-02-01), 20-25 1541-6933 18:1<20 2013 18 12028 https://doi.org/10.1007/s12028-012-9797-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9797-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Green Joel Department of Trauma, Saint Mary's Health Care, Grand Rapids, MI, USA aut NATIONALLICENCE 700 1- Pellegrini Daniela Department of Internal Medicine, University of Wisconsin-Madison, Madison, WI, USA aut NATIONALLICENCE 700 1- Vanderkolk Wayne Department of Trauma, Saint Mary's Health Care, Grand Rapids, MI, USA aut NATIONALLICENCE 700 1- Figueroa Bryan Department of Neurosurgery, Spectrum Health, Grand Rapids, MI, USA aut NATIONALLICENCE 700 1- Eriksson Evert Department of General Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 420, 29425, Charleston, SC, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/1(2013-02-01), 20-25 1541-6933 18:1<20 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer