Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage

Abstract Brain hypoxia can occur after non-traumatic subarachnoid hemorrhage (SAH), even when levels of intracranial pressure (ICP) remain normal. Brain tissue oxygenation (PbtO2) can be measured as a part of a neurological multimodal neuromonitoring. Low PbtO2 has been associated with poor neurolog...

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Autores principales:	Elisa Gouvea Bogossian, Daniela Diaferia, Narcisse Ndieugnou Djangang, Marco Menozzi, Jean-Louis Vincent, Marta Talamonti, Olivier Dewitte, Lorenzo Peluso, Sami Barrit, Mejdeddine Al Barajraji, Joachim Andre, Sophie Schuind, Jacques Creteur, Fabio Silvio Taccone
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e8b73e38d26048f78b890397879104fb
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spelling	oai:doaj.org-article:e8b73e38d26048f78b890397879104fb2021-12-02T15:07:55ZBrain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage10.1038/s41598-021-95602-62045-2322https://doaj.org/article/e8b73e38d26048f78b890397879104fb2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95602-6https://doaj.org/toc/2045-2322Abstract Brain hypoxia can occur after non-traumatic subarachnoid hemorrhage (SAH), even when levels of intracranial pressure (ICP) remain normal. Brain tissue oxygenation (PbtO2) can be measured as a part of a neurological multimodal neuromonitoring. Low PbtO2 has been associated with poor neurologic recovery. There is scarce data on the impact of PbtO2 guided-therapy on patients’ outcome. This single-center cohort study (June 2014–March 2020) included all patients admitted to the ICU after SAH who required multimodal monitoring. Patients with imminent brain death were excluded. Our primary goal was to assess the impact of PbtO2-guided therapy on neurological outcome. Secondary outcome included the association of brain hypoxia with outcome. Of the 163 patients that underwent ICP monitoring, 62 were monitored with PbtO2 and 54 (87%) had at least one episode of brain hypoxia. In patients that required treatment based on neuromonitoring strategies, PbtO2-guided therapy (OR 0.33 [CI 95% 0.12–0.89]) compared to ICP-guided therapy had a protective effect on neurological outcome at 6 months. In this cohort of SAH patients, PbtO2-guided therapy might be associated with improved long-term neurological outcome, only when compared to ICP-guided therapy.Elisa Gouvea BogossianDaniela DiaferiaNarcisse Ndieugnou DjangangMarco MenozziJean-Louis VincentMarta TalamontiOlivier DewitteLorenzo PelusoSami BarritMejdeddine Al BarajrajiJoachim AndreSophie SchuindJacques CreteurFabio Silvio TacconeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Elisa Gouvea Bogossian Daniela Diaferia Narcisse Ndieugnou Djangang Marco Menozzi Jean-Louis Vincent Marta Talamonti Olivier Dewitte Lorenzo Peluso Sami Barrit Mejdeddine Al Barajraji Joachim Andre Sophie Schuind Jacques Creteur Fabio Silvio Taccone Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage
description	Abstract Brain hypoxia can occur after non-traumatic subarachnoid hemorrhage (SAH), even when levels of intracranial pressure (ICP) remain normal. Brain tissue oxygenation (PbtO2) can be measured as a part of a neurological multimodal neuromonitoring. Low PbtO2 has been associated with poor neurologic recovery. There is scarce data on the impact of PbtO2 guided-therapy on patients’ outcome. This single-center cohort study (June 2014–March 2020) included all patients admitted to the ICU after SAH who required multimodal monitoring. Patients with imminent brain death were excluded. Our primary goal was to assess the impact of PbtO2-guided therapy on neurological outcome. Secondary outcome included the association of brain hypoxia with outcome. Of the 163 patients that underwent ICP monitoring, 62 were monitored with PbtO2 and 54 (87%) had at least one episode of brain hypoxia. In patients that required treatment based on neuromonitoring strategies, PbtO2-guided therapy (OR 0.33 [CI 95% 0.12–0.89]) compared to ICP-guided therapy had a protective effect on neurological outcome at 6 months. In this cohort of SAH patients, PbtO2-guided therapy might be associated with improved long-term neurological outcome, only when compared to ICP-guided therapy.
format	article
author	Elisa Gouvea Bogossian Daniela Diaferia Narcisse Ndieugnou Djangang Marco Menozzi Jean-Louis Vincent Marta Talamonti Olivier Dewitte Lorenzo Peluso Sami Barrit Mejdeddine Al Barajraji Joachim Andre Sophie Schuind Jacques Creteur Fabio Silvio Taccone
author_facet	Elisa Gouvea Bogossian Daniela Diaferia Narcisse Ndieugnou Djangang Marco Menozzi Jean-Louis Vincent Marta Talamonti Olivier Dewitte Lorenzo Peluso Sami Barrit Mejdeddine Al Barajraji Joachim Andre Sophie Schuind Jacques Creteur Fabio Silvio Taccone
author_sort	Elisa Gouvea Bogossian
title	Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage
title_short	Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage
title_full	Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage
title_fullStr	Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage
title_full_unstemmed	Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage
title_sort	brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e8b73e38d26048f78b890397879104fb
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Brain tissue oxygenation guided therapy and outcome in non-traumatic subarachnoid hemorrhage

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