Oleniuk D. V., Tsarov A. V.

DYNAMICS OF JUGULAR OXYGEN SATURATION LEVEL USING TARGET TEMPERATURE CONTROL IN PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

---

Show/Download

About the author:

Oleniuk D. V., Tsarov A. V.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Cerebral oxygenation level is an important prognostic factor in the treatment of patients with severe traumatic brain injury (TBI). Hypoxia, which significantly worsens clinical outcomes, can result from insufficient oxygen delivery to the brain or disrupted metabolism. The aim of this study was to investigate the effect of controlled normothermia on the oxygen saturation level in the jugular vein (SjvO2) in patients with severe TBI and hyperthermia. A total of 60 patients participated in the study, divided into a control group (n=30), which received standard antipyretic therapy, and an experimental group (n=30), where target temperature management was applied within the range of 36.5-37.5°C using the Blanketrol-II cooling system. Esophageal thermometry and invasive monitoring of SjvO2 levels were used. Statistical analysis was performed using standard methods via Jupyter Notebook (https:// jupyter.org). The study established that in the group with controlled normothermia, the SjvO2 level was significantly higher compared to the control group between days 3-7, reaching peak values on days 6-7. Correlation analysis revealed a strong inverse relationship between body temperature and SjvO2 levels, indicating worsening brain oxygenation with increasing hyperthermia. Thus, the obtained results confirm the effectiveness of controlled normothermia in improving cerebral oxygenation and suggest its use for optimizing intensive care in patients with severe TBI.

Tags:

Bibliography:

1. Godoy DA, Murillo-Cabezas F, Suarez JI, Badenes R, Pelosi P, Robba C. «THE MANTLE» bundle for minimizing cerebral hypoxia in severe traumatic brain injury. Crit Care. 2023;27(1):13. DOI: 10.1186/s13054-022-04242-3.
2. Zhong W, Ji Z, Sun C. A Review of Monitoring Methods for Cerebral Blood Oxygen Saturation. Healthcare (Basel). 2021;9(9):1104. DOI: 10.3390/health care9091104.
3. Godoy DA, Rubiano AM, Paranhos J, Robba C, Lazaridis C. Avoiding brain hypoxia in severe traumatic brain injury in settings with limited resources – A pathophysiological guide. J Crit Care. 2023;75:154260. DOI: 10.1016/j.jcrc. 2023.154260.
4. Sivakumar S, Taccone FS, Rehman M, Hinson H, Naval N, Lazaridis C. Hemodynamic and neuro-monitoring for neurocritically ill patients: An international survey of intensivists. J Crit Care. 2017;39:40-47. DOI: 10.1016/j.jcrc.2017.01.005.
5. Prabhakar H, editor. Neuromonitoring Techniques. Pittsburgh, PA: Academic Press; 2018. Chapter 3, Jugular venous oximetry; p. 57-75. DOI: 10.1016/B978-0-12-809915-5.00003-6.
6. Rubiano AM, Griswold DP, Jibaja M, Rabinstein AA, Godoy DA. Management of severe traumatic brain injury in regions with limited resources. Brain Inj. 2021;35(11):1317-1325. DOI: 10.1080/02699052.2021.1972149.
7. Richter J, Sklienka P, Chatterjee N, Maca J, Zahorec R, Burda M. Elevated jugular venous oxygen saturation after cardiac arrest. Resuscitation. 2021;169:214-219. DOI: 10.1016/j.resuscitation.2021.10.011.
8. Bhardwaj A, Bhagat H, Grover VK. Jugular venous oximetry. J Neuroanaesthesiol Crit Care. 2015;2:225-31. DOI: 10.4103/2348- 0548.165046.
9. Koht A, Sloan T, Toleikis J, eds. Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals. Cham: Springer; 2017. Chapter, Monitoring of jugular venous oxygen saturation; p. 229-242. DOI: 10.1007/978-3-319-46542-5_14.
10. Scarboro M, McQuillan KA. Traumatic Brain Injury Update. AACN Adv Crit Care. 2021;32(1):29-50. DOI: 10.4037/aacnacc2021331.
11. Richter J, Sklienka P, Setra AE, Zahorec R, Das S, Chatterjee N. Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients?. J Clin Monit Comput. 2021;35(4):741-748. DOI: 10.1007/s10877-020-00530-x.
12. Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80(1):6-15. DOI: 10.1227/NEU.000000000000 1432.
13. Sakurai A, Kinoshita K, Atsumi T, Moriya T, Utagawa A, Hayashi N. Relation between brain oxygen metabolism and temperature gradient between brain and bladder. Acta Neurochir Suppl. 2003;86:251-253. DOI: 10.1007/978-3-7091-0651-8_54.
14. Lavinio A, Coles JP, Robba C, Aries M, Bouzat P, Chean D, et al. Targeted temperature control following traumatic brain injury: ESICM/ NACCS best practice consensus recommendations. Crit Care. 2024;28(1):170. DOI: 10.1186/s13054-024-04951-x

Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 1, 176, 269-277 pages, index UDC 617.51-001.4

DOI:

10.29254/2077-4214-2025-1-176-269-277