Continuous Monitoring of Jugular Bulb Oxygen Saturation in the Management of Patients with Severe Closed Head Injury
Continuous monitoring of intracranial pressure (ICP) is essential in the management of the patients with severe head injury, and various methods to decrease ICP have been utilized . Hyperventilation, however, may occasionally cause inadequate cerebral perfusion, resulting in secondary brain damage in patients with increased ICP . We have performed experimental and clinical studies using simultaneous monitoring of ICP and jugular bulb oxygen saturation (SjO2) with a fiberoptic catheter to evaluate dynamic changes in cerebral perfusion and cerebral metabolic rate, with the aim of finding an appropriate treatment strategy for patients with severe head injury . On the basis of our previous data  and a review of the literature [4, 5], it was considered that a value for SjO2 less than 50% indicated hypoperfusion and a value more than 80% suggested hyperemia. We present herein our early experience of the management of severely head-injured patients by using simultaneous monitoring of ICP and SjO2 and discuss the treatment protocol we have developed.
KeywordsContinuous Monitoring Glasgow Coma Scale Score Severe Head Injury Cerebral Metabolic Rate Simultaneous Monitoring
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