• Naofumi Bunya, Wakiko Aisaka, Kei Miyata, Eichi Narimatsu, Susumu Yamashita, Yasuhiro Kuroda, Hitoshi Kobata, Tadashi Kaneko, Motoki Fujita, Kenji Dohi, Yasutaka Oda, Tsuyoshi Maekawa, and B-HYPO Study Group.
• Departments of Emergency Medicine, Sapporo Medical University, Hokkaido, Japan. Electronic address: naobun1221@gmail.com.
• World Neurosurg. 2020 May 1; 137: e68-e74.

BackgroundIn patients postcardiac arrest, it has been reported that the small value of the difference between mixed venous oxygen saturation (Svo2) and jugular venous oxygen saturation (Sjvo2) is associated with poor neurologic outcome. However, the importance of the difference between mixed venous oxygen saturation and jugular venous oxygen saturation (ΔSo2 [v - jv]) remains unknown in severe traumatic brain injury (TBI). The aim of this study was to examine whether ΔSo2 (v - jv) is associated with neurologic outcome and mortality in patients with severe TBI.MethodsWe conducted post hoc analyses of the Brain Hypothermia Study, a multicenter randomized controlled trial of mild therapeutic hypothermia for the treatment of severe TBI. The value of ΔSo2(v - jv) on day 1 and day 3 was compared between survivors (n = 65) and nonsurvivors (n = 25) or between patients with favorable (n = 47) and unfavorable (n = 43) neurologic outcomes.ResultsThe reduction in ΔSo2 (v - jv) on day 3 was -2.0% (range, -6.9% to 6.5%) in the nonsurvivor group and 6.3% (range, -2.5% to 16.7%) in the survivor group. The difference was statistically significant (P = 0.03). The same tendencies were observed in the nonsurvivor group on day 1 and in the unfavorable neurologic outcome group on day 1 and day 3, but the difference was not significant.ConclusionsThe reduction in ΔSo2(v - jv) on day 3 was associated with high mortality in patients with severe TBI.Copyright © 2020 Elsevier Inc. All rights reserved.

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