A lesson learned from jugular venous oximetry

The authors describe the case of a severely head injured patient whose prof ound cerebral infarction was clearly indicated by prolonged desaturation on jugular venous oximetry, Shortly thereafter jugular venous oxygen saturati on returned to normal stable values and measured within normal limits for t he next 24 h, As demonstrated by a computed tomography (CT) scan, these val ues appear to have represented a jugular mixture of significant amount of c erebral blood that had passed through infarcted tissue and remained highly saturated. This is a very graphic example of the misleading influence that regional flow-metabolic inhomogeneities can have on jugular venous saturati on and it emphasizes that cerebral ischemia can be easily missed ii no info rmation on cerebral blood flow or regional metabolism is available.