Related Experiment Video
Updated: Aug 7, 2026
07:51
Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
Open lung ventilation in neurosurgery: an update on brain tissue oxygenation
1Department of Neurosurgery, Academic Hospital Munich-Bogenhausen, Technical University of Munich, Munich, Germany. Neurochirurgie.Bogenhausen@lrz.tum.de
Acta Neurochirurgica. Supplement
|February 9, 2006
Summary
Brain tissue oxygenation monitoring guided lung recruitment in neurosurgical patients with acute respiratory distress syndrome (ARDS). This approach improved oxygenation without negatively impacting brain tissue oxygen levels.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Respiratory Physiology
Background:
- Neurosurgical patients with acute intracranial pathology often develop acute respiratory distress syndrome (ARDS).
- The Open Lung approach, involving low tidal volume and high positive expiratory pressure (PEEP), is feasible for ventilating these patients.
- Guiding recruitment maneuvers with brain tissue oxygenation (PbrO2) monitoring warrants investigation.
Purpose of the Study:
- To evaluate the use of PbrO2 probes to guide recruitment maneuvers in neurosurgical patients with ARDS.
- To assess the impact of recruitment maneuvers on both arterial oxygenation and brain tissue oxygenation.
Main Methods:
- Thirteen patients with ARDS and acute brain injury (subarachnoid hemorrhage, traumatic brain injury) were studied.
- PbrO2 probes were implanted in brain tissue at risk for hypoxia.
- Recruitment maneuvers were performed using high PEEP (30-40 cmH2O) and FiO2 of 1.0 for 40 seconds, with PbrO2 monitoring.
Main Results:
- Mean FiO2 required for normoxemia decreased significantly from 0.85 to 0.55 after 24 hours post-recruitment.
- Mean PbrO2 did not change significantly during the recruitment maneuvers themselves.
- A transient peak in PbrO2 was observed approximately 17 minutes after the first recruitment maneuver, indicating improved oxygen delivery.
Conclusions:
- Brain tissue oxygenation monitoring is a valuable tool for assessing the effects of recruitment maneuvers and ventilator settings in neurosurgical patients with ARDS.
- Lung recruitment strategies can improve systemic oxygenation in this population while maintaining adequate brain tissue oxygenation.
More Related Videos
Related Concept Videos
01:23Physiological Control of Respiration
Introduction
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
01:19Respiratory Assessment: Purpose and Indications
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...