Multimodal monitoring: head injury management using SjvO2 and LICOX

Monitoring methods following severe head injury currently use indirect measurements of cerebral oxygenation and perfusion defined as intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring. Adequate information regarding cerebral blood flow and oxygenation is necessary to guide treatment and prevent secondary cerebral ischemia. Because of the ineffectiveness of ICP and CPP monitoring in detecting early ischemic changes in healthy, as well as compromised, brain tissue, patients' neurological outcome and recovery may be less than optimal. New technology has been recently developed to provide early detection of poor cerebral oxygenation and perfusion. The LICOX brain tissue oxygenation and jugular venous bulb catheters are two types of monitors currently available. Patients can benefit from a unique combination of multimodal monitoring when cerebral oxygenation and consumption measurements are quantified on both a local and global level. This unique combination helps reflect early changes in brain tissue viability. As with any new monitoring device, there are associated advantages and disadvantages as well as cost issues, to consider. Patients with head injuries can benefit from technology that guides decisions and prevents treatment delays.