Clinical Experience with 118 Brain Tissue Oxygen Partial Pressure Catheter Probes

Clinical Experience with 118 Brain Tissue Oxygen Partial Pressure Catheter Probes AbstractOBJECTIVEWe assessed the technical and diagnostic reliability of partial pressure of oxygen (PO2) of brain tissue (P(ti)O2) monitoring. The monitoring system and the catheter probes were tested in vitro, and clinical experiences obtained with 118 brain P(ti)O2 catheter probes, used in 101 patients, are reported.METHODSThe polarographic (LICOX; Medical Systems Corp., Greenvale, NY) P(ti)O2 catheter probe lies 22 to 27 mm below the dura level; its PO2-sensitive surface is 7.1 mm2. For 10 patients, the adaptation time (with initially unreliable signals after insertion) was determined. For 27 patients, the probe was removed in a stepwise fashion (three increments of 5 mm) and the heterogeneity of brain P(ti)O2 levels was investigated. After removal of the catheter probes, their PO2 and zero display error values were determined and compared with probe performance data obtained in vitro with unused PO2 catheter probes.RESULTSSmall iatrogenic hematomas were observed for two patients (1.7%). No infection occurred after 6.7 ± 3.9 days (mean ± standard deviation) of monitoring. The technical complication (dislocation or defect) rate was 13.6%. The mean adaptation time was 79.0 ± 51.7 min. A flow chart is presented, which helps to rule out artifacts. The mean P(ti)O2 measured at 22 to 27 mm below the dura was 23.8 ± 8.1 mm Hg, at 17 to 22 mm was 25.7 ± 8.3 mm Hg, at 12 to 17 mm was 33.0 ± 13.3 mm Hg (P < 0.01, compared with the initial value), and at 7 to 12 mm was 33.3 ± 13.3 mm Hg (P < 0.01). Recent catheter probe versions exhibited a PO2 display error of −1.2 ± 5.1 % (mean ± standard deviation, n = 38) and a mean zero display error of 1.1 ± 0.9 mm Hg (n = 34). The greatest PO2 display errors were measured during the first 4 days of continuous monitoring. In the in vitro test (of 12 unused catheter probes), the maximal probe display error was 1.07 ± 2.14%, tested at temperatures between 22°C and 37°C and tested at oxygen pressures of 0, 44, and 150 mm Hg. In vitro, the zero display error was −0.21 ± 0.25 mm Hg.CONCLUSIONBrain P(ti)O2 monitoring, reflecting an area 17 to 27 mm below the dura, is a safe and reliable technique for monitoring cerebral oxygenation. Excluding the first 1 hour after insertion, data are reliable, with almost 100% good data quality. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Clinical Experience with 118 Brain Tissue Oxygen Partial Pressure Catheter Probes

Clinical Experience with 118 Brain Tissue Oxygen Partial Pressure Catheter Probes

CLINICAL STUDIES C lin ica l Experience with 118 Brain Tissue Oxygen Partial Pressure Catheter Probes Jim Dings, M.D., Jurgen Meixensberger, M.D., Ph.D., Andreas Jager, Klaus Roosen, M.D., Ph.D. Department of Neurosurgery, University of Wurzburg, Wurzburg, Germany O B JE C T IV E : We assessed the technical and diagnostic reliability of partial pressure of oxygen ( P 0 2) of brain tissue ( P ( t i) 0 2) monitoring. The monitoring system and the catheter probes were tested in vitro, and clin ic a l experiences obtained with 118 brain P ( t i) 0 2 catheter probes, used in 101 patients, are reported. M E T H O D S : The polarographic (L IC O X ; Medical Systems C orp., Greenvale, N Y) P ( t i) 0 2 catheter probe lies 22 to 2’ mm below the dura level; its P 0 2-sensitive surface is 7.1 m m 2. For 10 patients, the adaptation time (with initially unreliable signals after insertion) was determined. For 27 patients, the probe was removed in a stepwise fashion (three increments of 5 mm) and the heterogeneity of brain P ( t i) 0 2 levels was investigated. After removal of the catheter probes, their P 0 2 and zero display error values were determined and compared with probe performance data obtained in vitro with unused P 0 2 catheter probes. R ESU LTS: Small iatrogenic hematomas were observed for two patients (1 .7 % ). No infection occurred after 6.7 ± 3.9 days (mean ± standard deviation) of monitoring. The technical com plication (dislocation or defect) rate w as 1 3 .6 % . The mean adaptation time was 79.0 ± 51.7 min. A flow chart is presented, w hich helps to rule out artifacts. The mean P ( t i) 0 2 measured at 22 to 27 mm below the dura was 23.8 ± 8.1 mm Hg, at 17 to 22 m m was 25.7 ± 8.3 mm Hg, at 12 to 17 mm was 33.0 ± 13.3 mm H g (P < 0.01, compared with the initial value), and at 7 to 12 mm was 33.3 ± 13.3 mm H g (P < 0.01). Recent catheter probe versions exhibited a P 0 2 display error of —1.2...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199811000-00045
Publisher site
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Abstract

AbstractOBJECTIVEWe assessed the technical and diagnostic reliability of partial pressure of oxygen (PO2) of brain tissue (P(ti)O2) monitoring. The monitoring system and the catheter probes were tested in vitro, and clinical experiences obtained with 118 brain P(ti)O2 catheter probes, used in 101 patients, are reported.METHODSThe polarographic (LICOX; Medical Systems Corp., Greenvale, NY) P(ti)O2 catheter probe lies 22 to 27 mm below the dura level; its PO2-sensitive surface is 7.1 mm2. For 10 patients, the adaptation time (with initially unreliable signals after insertion) was determined. For 27 patients, the probe was removed in a stepwise fashion (three increments of 5 mm) and the heterogeneity of brain P(ti)O2 levels was investigated. After removal of the catheter probes, their PO2 and zero display error values were determined and compared with probe performance data obtained in vitro with unused PO2 catheter probes.RESULTSSmall iatrogenic hematomas were observed for two patients (1.7%). No infection occurred after 6.7 ± 3.9 days (mean ± standard deviation) of monitoring. The technical complication (dislocation or defect) rate was 13.6%. The mean adaptation time was 79.0 ± 51.7 min. A flow chart is presented, which helps to rule out artifacts. The mean P(ti)O2 measured at 22 to 27 mm below the dura was 23.8 ± 8.1 mm Hg, at 17 to 22 mm was 25.7 ± 8.3 mm Hg, at 12 to 17 mm was 33.0 ± 13.3 mm Hg (P < 0.01, compared with the initial value), and at 7 to 12 mm was 33.3 ± 13.3 mm Hg (P < 0.01). Recent catheter probe versions exhibited a PO2 display error of −1.2 ± 5.1 % (mean ± standard deviation, n = 38) and a mean zero display error of 1.1 ± 0.9 mm Hg (n = 34). The greatest PO2 display errors were measured during the first 4 days of continuous monitoring. In the in vitro test (of 12 unused catheter probes), the maximal probe display error was 1.07 ± 2.14%, tested at temperatures between 22°C and 37°C and tested at oxygen pressures of 0, 44, and 150 mm Hg. In vitro, the zero display error was −0.21 ± 0.25 mm Hg.CONCLUSIONBrain P(ti)O2 monitoring, reflecting an area 17 to 27 mm below the dura, is a safe and reliable technique for monitoring cerebral oxygenation. Excluding the first 1 hour after insertion, data are reliable, with almost 100% good data quality.

Journal

NeurosurgeryOxford University Press

Published: Nov 1, 1998

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