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Erschienen in: Neurocritical Care 1/2013

01.08.2013 | Original Article

The Oxygen Reactivity Index and Its Relation to Sensor Technology in Patients with Severe Brain Lesions

verfasst von: Julius Dengler, Christin Frenzel, Peter Vajkoczy, Peter Horn, Stefan Wolf

Erschienen in: Neurocritical Care | Ausgabe 1/2013

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Abstract

Background

The oxygen reactivity index (ORx) has been introduced to assess the status of cerebral autoregulation after traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). Currently, there is some controversy about whether the ORx depends on the type of PbrO2-sensor technology used for its calculation. To examine if the probe technology does matter, we compared the ORx and the resulting optimal cerebral perfusion pressures (CPPopt) of simultaneously implanted Licox (CC1.SB, Integra Neuroscience, France) and Neurovent-PTO (Raumedic, Germany) probes in patients after aneurysmal SAH or severe TBI.

Methods

Licox and Raumedic probes were implanted side by side in 11 patients after TBI or SAH. ORx and CPPopt were recorded continuously. The equivalence of both probes was examined using Bland–Altman analyses.

Results

The mean difference in ORx was 0.1, with Licox producing higher values. The limits of agreement regarding ORx ranged from −0.6 to +0.7. When both probes’ ORx values were compared in each patient, no specific pattern in their relationship was seen. The mean difference in CPPopt was 0 mmHg with limits of agreement between −16.5 and +16.4 mmHg.

Conclusions

Owing to the rather limited number of patients, we view the results of this study as preliminary. The main result is that Licox and Raumedic showed consistent differences in ORx and CPPopt. Therefore, ORx values of both probes cannot be interchanged and should not be viewed as equivalent. This should be taken into consideration when discussing ORx data generated by different PbrO2 probe types.
Literatur
1.
Zurück zum Zitat Sorrentino E, Diedler J, Kasprowicz M, et al. Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care. 2011. doi:10.1007/s12028-011-9630-8. Sorrentino E, Diedler J, Kasprowicz M, et al. Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care. 2011. doi:10.​1007/​s12028-011-9630-8.
2.
Zurück zum Zitat Czosnyka M, Balestieri M, Steiner L, et al. Age, intracranial pressure, autoregulation, and outcome after brain injury. J Neurosurg. 2005;102:450–1.PubMedCrossRef Czosnyka M, Balestieri M, Steiner L, et al. Age, intracranial pressure, autoregulation, and outcome after brain injury. J Neurosurg. 2005;102:450–1.PubMedCrossRef
3.
Zurück zum Zitat Jaeger M, Schuhmann MU, Soehle M, Meixensberger J. Continuous assessment of cerebrovascular autoregulation after traumatic brain injury using brain tissue oxygen pressure reactivity. Crit Care Med. 2006;34(6):1783–8.PubMedCrossRef Jaeger M, Schuhmann MU, Soehle M, Meixensberger J. Continuous assessment of cerebrovascular autoregulation after traumatic brain injury using brain tissue oxygen pressure reactivity. Crit Care Med. 2006;34(6):1783–8.PubMedCrossRef
4.
Zurück zum Zitat Jaeger M, Schuhmann MU, Soehle M, Nagel C, Meixensberger J. Continuous monitoring of cerebrovascular autoregulation after subarachnoid hemorrhage by brain tissue oxygen pressure reactivity and its relation to delayed cerebral infarction. Stroke. 2007;38(3):981–6.PubMedCrossRef Jaeger M, Schuhmann MU, Soehle M, Nagel C, Meixensberger J. Continuous monitoring of cerebrovascular autoregulation after subarachnoid hemorrhage by brain tissue oxygen pressure reactivity and its relation to delayed cerebral infarction. Stroke. 2007;38(3):981–6.PubMedCrossRef
5.
Zurück zum Zitat Radolovich DK, Czosnyka M, Timofeev I, et al. Reactivity of brain tissue oxygen to change in cerebral perfusion pressure in head injured patients. Neurocrit Care. 2009;10(3):274–9.PubMedCrossRef Radolovich DK, Czosnyka M, Timofeev I, et al. Reactivity of brain tissue oxygen to change in cerebral perfusion pressure in head injured patients. Neurocrit Care. 2009;10(3):274–9.PubMedCrossRef
6.
Zurück zum Zitat Jaeger M. Different indices to assess cerebrovascular autoregulation have different dynamic properties. Neurocrit Care. 2010;13(1):163–5.PubMedCrossRef Jaeger M. Different indices to assess cerebrovascular autoregulation have different dynamic properties. Neurocrit Care. 2010;13(1):163–5.PubMedCrossRef
7.
Zurück zum Zitat Dengler J, Frenzel C, Vajkoczy P, Wolf S, Horn P. Cerebral tissue oxygenation measured by two different probes: challenges and interpretation. Intensive Care Med. 2011;37(11):1809–15.PubMedCrossRef Dengler J, Frenzel C, Vajkoczy P, Wolf S, Horn P. Cerebral tissue oxygenation measured by two different probes: challenges and interpretation. Intensive Care Med. 2011;37(11):1809–15.PubMedCrossRef
9.
Zurück zum Zitat Steiner LA, Czosnyka M, Piechnik SK, et al. Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury. Crit Care Med. 2002;30(4):733–8.PubMedCrossRef Steiner LA, Czosnyka M, Piechnik SK, et al. Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury. Crit Care Med. 2002;30(4):733–8.PubMedCrossRef
10.
Zurück zum Zitat Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.PubMedCrossRef Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.PubMedCrossRef
11.
Zurück zum Zitat Myles PS, Cui J. Using the Bland–Altman method to measure agreement with repeated measures. Br J Anaesth. 2007;99(3):309–11.PubMedCrossRef Myles PS, Cui J. Using the Bland–Altman method to measure agreement with repeated measures. Br J Anaesth. 2007;99(3):309–11.PubMedCrossRef
12.
Zurück zum Zitat Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17(4):571–82.PubMedCrossRef Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17(4):571–82.PubMedCrossRef
13.
Zurück zum Zitat Critchley LA, Critchley JA. A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput. 1999;15(2):85–91.PubMedCrossRef Critchley LA, Critchley JA. A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput. 1999;15(2):85–91.PubMedCrossRef
14.
Zurück zum Zitat Haitsma I, Rosenthal G, Morabito D, Rollins M, Maas AI, Manley GT. In vitro comparison of two generations of Licox and Neurotrend catheters. Acta Neurochir Suppl (Wien). 2008;102:197–202.CrossRef Haitsma I, Rosenthal G, Morabito D, Rollins M, Maas AI, Manley GT. In vitro comparison of two generations of Licox and Neurotrend catheters. Acta Neurochir Suppl (Wien). 2008;102:197–202.CrossRef
15.
Zurück zum Zitat Hoelper BM, Alessandri B, Heimann A, Behr R, Kempski O. Brain oxygen monitoring: in vitro accuracy, long-term drift and response-time of Licox- and Neurotrend sensors. Acta Neurochir (Wien). 2005;47:767–74.CrossRef Hoelper BM, Alessandri B, Heimann A, Behr R, Kempski O. Brain oxygen monitoring: in vitro accuracy, long-term drift and response-time of Licox- and Neurotrend sensors. Acta Neurochir (Wien). 2005;47:767–74.CrossRef
16.
Zurück zum Zitat Purins K, Enblad P, Sandhagen B, Lewen A. Brain tissue oxygen monitoring: a study of in vitro accuracy and stability of Neurovent-PTO and Licox sensors. Acta Neurochir (Wien). 2005;152(4):681–8.CrossRef Purins K, Enblad P, Sandhagen B, Lewen A. Brain tissue oxygen monitoring: a study of in vitro accuracy and stability of Neurovent-PTO and Licox sensors. Acta Neurochir (Wien). 2005;152(4):681–8.CrossRef
17.
Zurück zum Zitat Orakciouglu B, Sakowitz OW, Neumann JO, Kentar MM, Unterberg A, Kiening KL. Evaluation of a novel brain tissue oxygenation probe in an experimental swine model. Neurosurgery. 2010;67(6):1716–22.CrossRef Orakciouglu B, Sakowitz OW, Neumann JO, Kentar MM, Unterberg A, Kiening KL. Evaluation of a novel brain tissue oxygenation probe in an experimental swine model. Neurosurgery. 2010;67(6):1716–22.CrossRef
18.
Zurück zum Zitat Huschak G, Hoell T, Hohaus C, Kern C, Minkus Y, Meisel HJ. Clinical evaluation of a new multiparameter neuromonitoring device: measurement of brain tissue oxygen, brain temperature, and intracranial pressure. J Neurosurg Anesthesiol. 2009;21(2):155–60.PubMedCrossRef Huschak G, Hoell T, Hohaus C, Kern C, Minkus Y, Meisel HJ. Clinical evaluation of a new multiparameter neuromonitoring device: measurement of brain tissue oxygen, brain temperature, and intracranial pressure. J Neurosurg Anesthesiol. 2009;21(2):155–60.PubMedCrossRef
19.
Zurück zum Zitat Barth M, Woitzik J, Weiss C, et al. Correlation of clinical outcome with pressure-, oxygen-, and flow-related indices of cerebrovascular reactivity in patients following aneurysmal SAH. Neurocrit Care. 2009;12(2):234–43.CrossRef Barth M, Woitzik J, Weiss C, et al. Correlation of clinical outcome with pressure-, oxygen-, and flow-related indices of cerebrovascular reactivity in patients following aneurysmal SAH. Neurocrit Care. 2009;12(2):234–43.CrossRef
Metadaten
Titel
The Oxygen Reactivity Index and Its Relation to Sensor Technology in Patients with Severe Brain Lesions
verfasst von
Julius Dengler
Christin Frenzel
Peter Vajkoczy
Peter Horn
Stefan Wolf
Publikationsdatum
01.08.2013
Verlag
Springer US
Erschienen in
Neurocritical Care / Ausgabe 1/2013
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-012-9686-0

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