Neurologic Outcomes with Cerebral Oxygen Monitoring in Traumatic Brain Injury

Mary C. McCarthy; Hugh Moncrief; Jean M. Sands; Ronald J. Markert; Lawrence C. Hall; Ian C. Wenker; Harry L. Anderson; Akpofure Peter Ekeh; Mbaga S. Walusimbi; Randy J. Woods; Jonathan M. Saxe; Kathryn M. Tchorz

doi:10.1016/j.surg.2009.06.059

Neurologic Outcomes with Cerebral Oxygen Monitoring in Traumatic Brain Injury

Mary C. McCarthy, Hugh Moncrief, Jean M. Sands, Ronald J. Markert, Lawrence C. Hall, Ian C. Wenker, Harry L. Anderson, Akpofure Peter Ekeh, Mbaga S. Walusimbi, Randy J. Woods, Jonathan M. Saxe, Kathryn M. Tchorz

Research output: Contribution to journal › Article › peer-review

Abstract

<p> <h4 id="x-x-x-absSec_1"> Background </h4> <p id="x-x-x-simple-para0015"> Optimizing cerebral oxygenation is advocated to improve outcome in head-injured patients. The purpose of this study was to compare outcomes in brain-injured patients treated with 2 types of monitors. <h4 id="x-x-x-absSec_2"> Methods </h4> <p id="x-x-x-simple-para0020"> Patients with traumatic brain injury and a Glasgow Coma Scale score/pressure monitor (Licox) or fiberoptic intracranial pressure monitor (Camino) was inserted. An evidence-based algorithm for treatment was implemented. Elements from the prehospital and emergency department records and the first 10 days of intensive care unit (ICU) care were collected. Glasgow Outcome Scores (GOS) were determined every 3 months after discharge. <h4 id="x-x-x-absSec_3"> Results </h4> <p id="x-x-x-simple-para0025"> Over a 3-year period, 145 patients were entered into the study; 81 patients in the Licox group and 64 patients in the Camino group. Mortality, hospital length of stay, and ICU length of stay were equivalent in the 2 groups. More patients in the Licox group achieved a moderate/recovered GOS at 3 months than in the Camino Group (79% vs 61%; <em> P </em> = .09). <h4 id="x-x-x-absSec_4"> Conclusion </h4> <p id="x-x-x-simple-para0030"> Three-month GOS revealed a clinically meaningful 18% benefit in patients undergoing cerebral oxygen monitoring and optimization. Six-month outcomes were also better. Unfortunately, these important differences did not reach significance. Continued study of the benefits of cerebral oxygen monitoring is warranted. </p> </p> </p> </p></p>

Original language	American English
Journal	Surgery
Volume	146
DOIs	https://doi.org/10.1016/j.surg.2009.06.059
State	Published - Oct 1 2009

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Medicine and Health Sciences
Surgery

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@article{9fff7bb17a3c4f8ab333099d125735a1,

title = "Neurologic Outcomes with Cerebral Oxygen Monitoring in Traumatic Brain Injury",

abstract = " Background Optimizing cerebral oxygenation is advocated to improve outcome in head-injured patients. The purpose of this study was to compare outcomes in brain-injured patients treated with 2 types of monitors. Methods Patients with traumatic brain injury and a Glasgow Coma Scale score/pressure monitor (Licox) or fiberoptic intracranial pressure monitor (Camino) was inserted. An evidence-based algorithm for treatment was implemented. Elements from the prehospital and emergency department records and the first 10 days of intensive care unit (ICU) care were collected. Glasgow Outcome Scores (GOS) were determined every 3 months after discharge. Results Over a 3-year period, 145 patients were entered into the study; 81 patients in the Licox group and 64 patients in the Camino group. Mortality, hospital length of stay, and ICU length of stay were equivalent in the 2 groups. More patients in the Licox group achieved a moderate/recovered GOS at 3 months than in the Camino Group (79% vs 61%; P = .09). Conclusion Three-month GOS revealed a clinically meaningful 18% benefit in patients undergoing cerebral oxygen monitoring and optimization. Six-month outcomes were also better. Unfortunately, these important differences did not reach significance. Continued study of the benefits of cerebral oxygen monitoring is warranted. ",

author = "McCarthy, {Mary C.} and Hugh Moncrief and Sands, {Jean M.} and Markert, {Ronald J.} and Hall, {Lawrence C.} and Wenker, {Ian C.} and Anderson, {Harry L.} and Ekeh, {Akpofure Peter} and Walusimbi, {Mbaga S.} and Woods, {Randy J.} and Saxe, {Jonathan M.} and Tchorz, {Kathryn M.}",

year = "2009",

month = oct,

day = "1",

doi = "10.1016/j.surg.2009.06.059",

language = "American English",

volume = "146",

journal = "Surgery",

}

TY - JOUR

T1 - Neurologic Outcomes with Cerebral Oxygen Monitoring in Traumatic Brain Injury

AU - McCarthy, Mary C.

AU - Moncrief, Hugh

AU - Sands, Jean M.

AU - Markert, Ronald J.

AU - Hall, Lawrence C.

AU - Wenker, Ian C.

AU - Anderson, Harry L.

AU - Ekeh, Akpofure Peter

AU - Walusimbi, Mbaga S.

AU - Woods, Randy J.

AU - Saxe, Jonathan M.

AU - Tchorz, Kathryn M.

PY - 2009/10/1

Y1 - 2009/10/1

N2 - Background Optimizing cerebral oxygenation is advocated to improve outcome in head-injured patients. The purpose of this study was to compare outcomes in brain-injured patients treated with 2 types of monitors. Methods Patients with traumatic brain injury and a Glasgow Coma Scale score/pressure monitor (Licox) or fiberoptic intracranial pressure monitor (Camino) was inserted. An evidence-based algorithm for treatment was implemented. Elements from the prehospital and emergency department records and the first 10 days of intensive care unit (ICU) care were collected. Glasgow Outcome Scores (GOS) were determined every 3 months after discharge. Results Over a 3-year period, 145 patients were entered into the study; 81 patients in the Licox group and 64 patients in the Camino group. Mortality, hospital length of stay, and ICU length of stay were equivalent in the 2 groups. More patients in the Licox group achieved a moderate/recovered GOS at 3 months than in the Camino Group (79% vs 61%; P = .09). Conclusion Three-month GOS revealed a clinically meaningful 18% benefit in patients undergoing cerebral oxygen monitoring and optimization. Six-month outcomes were also better. Unfortunately, these important differences did not reach significance. Continued study of the benefits of cerebral oxygen monitoring is warranted.

AB - Background Optimizing cerebral oxygenation is advocated to improve outcome in head-injured patients. The purpose of this study was to compare outcomes in brain-injured patients treated with 2 types of monitors. Methods Patients with traumatic brain injury and a Glasgow Coma Scale score/pressure monitor (Licox) or fiberoptic intracranial pressure monitor (Camino) was inserted. An evidence-based algorithm for treatment was implemented. Elements from the prehospital and emergency department records and the first 10 days of intensive care unit (ICU) care were collected. Glasgow Outcome Scores (GOS) were determined every 3 months after discharge. Results Over a 3-year period, 145 patients were entered into the study; 81 patients in the Licox group and 64 patients in the Camino group. Mortality, hospital length of stay, and ICU length of stay were equivalent in the 2 groups. More patients in the Licox group achieved a moderate/recovered GOS at 3 months than in the Camino Group (79% vs 61%; P = .09). Conclusion Three-month GOS revealed a clinically meaningful 18% benefit in patients undergoing cerebral oxygen monitoring and optimization. Six-month outcomes were also better. Unfortunately, these important differences did not reach significance. Continued study of the benefits of cerebral oxygen monitoring is warranted.

UR - https://corescholar.libraries.wright.edu/surg/22

U2 - 10.1016/j.surg.2009.06.059

DO - 10.1016/j.surg.2009.06.059

M3 - Article

C2 - 19789016

VL - 146

JO - Surgery

JF - Surgery

ER -

Neurologic Outcomes with Cerebral Oxygen Monitoring in Traumatic Brain Injury

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