ANALYSIS OF ABNORMAL JUGULAR BULB OXYGEN-SATURATION DATA IN PATIENTS WITH SEVERE HEAD-INJURY

Jugular bulb oximetry provides the first bedside, continuously availab le information on cerebral perfusion adequacy. An extensive analysis w as made of all jugular bulb oxygen saturation (SjO(2)) data obtained i n 50 patients suffering from severe head injury. A total of 176 period s (more than 30 minutes) with reliable, abnormal SjO(2)-values was obs erved, with 62 desaturation periods (SjO(2) < 55%) and 114 high SjO(2) -periods (SjO(2) > 80%). Jugular desaturation periods were predominant ly observed in the first 2 days of monitoring and seemed the most clos ely correlated to lowered cerebral perfusion pressure and lowered arte rial carbon dioxide tension. The high SjO(2)-values were more equally distributed over the first 5 days of monitoring and seemed mostly corr elated to increased arterial carbon dioxide tension. Highlights of the general management of severely head injured patients is discussed, fo cussing attention on the importance of cerebral perfusion pressure and normoventilation.