Related Experiment Video
Updated: Jun 27, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Brain tissue oxygenation changes in children during the first 24 h following head injury
1Department of Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, U.K.
Insights
In pediatric severe head injuries, fluctuating brain oxygen levels (PbtO2) can occur with increased intracranial pressure (ICP). However, low brain oxygenation in the first 24 hours doesn't always predict poor clinical outcomes.
Area of Science:
- Pediatric Neurology
- Neurocritical Care
- Trauma Surgery
Background:
- Severe head injuries in children present complex management challenges.
- Monitoring brain tissue oxygenation is crucial for understanding injury pathophysiology.
Purpose of the Study:
- To evaluate brain tissue oxygen levels in children within 24 hours of head injury.
- To correlate these oxygen levels with intracranial pressure (ICP) and clinical outcomes.
Main Methods:
- Invasive monitoring of partial brain tissue oxygen tension (PbtO2) using Licox probes.
- Data collected from pediatric patients with severe head injury requiring ventilation.
Main Results:
- Mean PbtO2 varied significantly among the four pediatric patients.
- Elevated ICP episodes often coincided with decreased PbtO2.
- Despite initial low PbtO2, three out of four patients achieved good recovery at one year.
Conclusions:
- Increased ICP in pediatric head injury can lead to reduced brain oxygenation.
- Low PbtO2 in the initial 24 hours post-injury does not invariably predict a poor long-term clinical outcome.
Aim:
The aim of this study is to assess the changes of brain tissue oxygen levels in children during the first 24 h following head injury and its correlation with changes of intracranial pressure and clinical outcome.
Method:
Invasive monitoring of partial brain tissue oxygen tension (PbtO(2)) using the Licox (Integra Neurosciences, Plainsboro, NJ, USA) oxygen probe was performed in children with severe head injury requiring ventilation, during the years 2002-2005. The study focused in the recordings of the first 24 h following injury.
Results:
There were four patients (three males, one female) with an age range of 2-12 years. All injuries were due to motor vehicle accidents. The Glasgow Coma Score ranged from 5 to 9. All patients had diffuse axonal injuries on Computed Tomography scan. One patient underwent a bilateral decompressive craniectomy. The total duration of monitoring was 567.84 h. During the first 24 h, the mean PbtO(2) was 4.2 mmHg, 12.7 mmHg, 21.8 mmHg, and 25.1 mmHg in each patient. Fifteen episodes of ICP>20 mmHg were seen in the first 24 h of monitoring. Nine of these episodes were accompanied by a reduction in PbtO(2) levels. The Glasgow Outcome Score at 1 year was good recovery (GOS 3) in three patients and severe disability in one patient. There were no complications from the monitoring.
Conclusions:
In children with head injury, rise in ICP may be accompanied by fall in PbtO(2). However, low brain oxygen levels during the first 24 h following head injury may not correlate necessarily with poor outcome.
