• Santiago R Leal-Noval, Aurelio Cayuela, Victoria Arellano-Orden, Antonio Marín-Caballos, Vicente Padilla, Carmen Ferrándiz-Millón, Yael Corcia, Claudio García-Alfaro, Rosario Amaya-Villar, and Francisco Murillo-Cabezas.
• Neuro Critical Care Division, Hospital Universitario Virgen del Rocío, Seville, Spain. srleal@telefonica.net
• Intensive Care Med. 2010 Aug 1;36(8):1309-17.

PurposeThe aim of this study is to investigate the relationship between invasive brain tissue oxygen pressure (PbrO(2)) and noninvasive regional transcranial oxygen saturation (rSO(2)) in 22 stable patients with severe traumatic brain injury (TBI) during a 16 h period.MethodsThis was a prospective, observational study carried out in the Neurocritical Care Unit of a level 1 trauma center in a teaching hospital. A total of 41,809 paired records for neuromonitoring variables were analyzed and compared.ResultsA direct and independent correlation between rSO(2) and PbrO(2) was confirmed through adjusted [beta coefficient and (95% confidence interval, CI) = 0.36 (0.35-0.37)] and logistic [PbrO(2) >or=15 mmHg, as a dependent variable; adjusted odds ratio (AOR) and (95% CI) = 1.11 (1.10-1.12)] regression analyses. A receiver-operating characteristic (ROC) curve demonstrated that rSO(2) had low accuracy for detecting moderate (PbrO(2) ConclusionsIn patients with severe TBI, PbrO(2) and rSO(2) were directly and significantly related. Severe intracerebral hypoxia was better detected by rSO(2) than was moderate intracerebral hypoxia. However, the diagnostic accuracy of rSO(2) was limited, and this measure should not be considered a substitute for routine PbrO(2) monitoring.

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