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Measurements of cortical cellular pH by intracranial tonometer in severe head injury
1Department of Emergency and Critical Care Medicine, Tama-Nagayama Hospital, Nippon Medical School, Tama-city, Tokyo, Japan.
Objective:
To evaluate the cortical cellular damage in acute severe head injury, we measured the cortical cellular pH by using an intracranial tonometer made in our institution.
Design:
Prospective, 3.5-yr data collection.
Setting:
University hospital trauma intensive care unit.
Patients:
Severely head-injured patients (n = 29) with Glasgow Coma Scale score <8.
Intervention:
Routine emergency neurologic procedure.
Measurements And Main Results:
We made 98 measurements of cortical cellular pH by intracranial tonometer in 29 severely head-injured patients in the acute phase. Each patient's intracranial pressure was recorded, and in 16 patients, the saturation of jugular venous oxygen was monitored. The outcome at 6 months after injury was significantly better in patients having a cortical cellular pH of >7.2 than those with <7.2. The cerebral perfusion pressure and cortical cellular pH correlated significantly (p < .0001).
Conclusions:
Our study suggests the usefulness of measurement of cortical cellular pH by intracranial tonometer for evaluating the severity of focal anaerobic cerebral metabolism and predicting patient prognosis.