Utilidad clínica de la monitorización de la saturación de oxígeno en el bulbo de la yugular en los pacientes con traumatismo craneoencefálico grave
Clinical usefulness of jugular bulb oxygen saturation monitoring in severe head injury patients
A.J. Betbesé Roig, M. Pérez Márquez, L. Marruecos Sant, E. Bak, G. Rialp Cervera, J. Ballús Noguera, A. Net Castel
Servicio de Medicina Intensiva. Hospital de la Santa Creu i Sant Pau. Universidad Autónoma de Barcelona. Barcelona
I. Gich*
* Instituto de Investigación. Hospital de la Santa Creu i Sant Pau. Universidad Autónoma de Barcelona. Barcelona
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"apellidos" => "Marruecos Sant" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Bak" ] 4 => array:2 [ "nombre" => "G." "apellidos" => "Rialp Cervera" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Ballús Noguera" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Net Castel" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Medicina Intensiva. Hospital de la Santa Creu i Sant Pau. Universidad Autónoma de Barcelona. Barcelona" ] ] ] 1 => array:3 [ "autoresLista" => "I. Gich" "autores" => array:1 [ 0 => array:3 [ "nombre" => "I." "apellidos" => "Gich" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Instituto de Investigación. Hospital de la Santa Creu i Sant Pau. Universidad Autónoma de Barcelona. Barcelona" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical usefulness of jugular bulb oxygen saturation monitoring in severe head injury patients" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec163350" "palabras" => array:5 [ 0 => "Presión de perfusión cerebral, presión intracraneal" 1 => "Bulbo yugular" 2 => "Hiperventilación" 3 => "Acoplamiento metabólico" 4 => "Hipoperfusión" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec163351" "palabras" => array:6 [ 0 => "Cerebral perfusion pressure" 1 => "Intracranial pressure" 2 => "Jugular bulb" 3 => "Hyperventilation" 4 => "Metabolic coupling" 5 => "Hypoperfusion" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Valorar la relación de la saturación de oxígeno en el bulbo de la vena yugular (SatY O<span class="elsevierStyleInf">2</span>) con las imágenes obtenidas en la tomografía computarizada (TC) cerebral y con la mortalidad de los pacientes con traumatismo craneoencefálico (TCE) grave atendidos en nuestro Servicio de Cuidados Intensivos generales.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudiamos 28 pacientes con TCE grave (Glasgow Coma Score 6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2 a su ingreso). Se objetivó la SatY O<span class="elsevierStyleInf">2</span> y el índice oxígeno-lactato mediante la colocación de un catéter convencional en el bulbo de una vena yugular. Las lesiones objetivadas por la TC cerebral se clasificaron en difusas, focales o mixtas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron un total de 282 determinaciones analíticas de la sangre del bulbo de la vena yugular que permitieron clasificar la situación hemodinámica cerebral (HC) como hiperemia, normalidad, hipoperfusión o isquemia global. En los pacientes que no fallecieron (NF) se obtuvo un 81% de mediciones de SatY O<span class="elsevierStyleInf">2</span> dentro de la normalidad, mientras que sólo la presentaron un 19% de los que fallecieron (F) (P: 0,007). No observamos relación entre la SatY O<span class="elsevierStyleInf">2</span>, con las lesiones objetivadas por la TC con la clasificación utilizada.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La monitorización de la SatY O<span class="elsevierStyleInf">2</span> se correlaciona con la mortalidad en el paciente con TCE grave. No observamos correlación entre las variables hemodinámicas cerebrales estudiadas con la TC.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To study the relationship between the oxygen saturation measured at the jugular bulb (SatY O<span class="elsevierStyleInf">2</span>) with cerebral computerized tomography (CT) findings and mortality in severe head injury patients.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We studied 28 severe head injury patients (Glasgow Coma Score: 6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2 at admission). SatY O<span class="elsevierStyleInf">2</span> and lactate-oxygen index were measured through a conventional catheter implanted at one jugular bulbo CT brain injuries were classified as diffuse, focal or mixed.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We performed 282 analytic determinations of jugular blood samples and classified the hemodynamis status as hyperemic, normal, hypoperfusion and ischemic. 81% of the survivors had SatY O<span class="elsevierStyleInf">2</span> value within normal limits in comparison to only 19% of patients who died (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.007). However, there was no a significant correlation between SatY O<span class="elsevierStyleInf">2</span> values and the CT findings.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Oxigen saturation measured at the yugular bulb correlated with mortality rate in severe head injury patients but the different hemodynamic patteros did not associate with the intracranial pathology an estimated by CT sean.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Betbesé Roig, A.J.; Pérez Márquez, M; Marruecos Sant, L.; Bak, E.; Rialp Cervera, G.; Ballús Noguera, J.; Net Castel, A.; Gich, I: Utilidad clínica de la monitorización de la saturación de oxígeno en el bulbo de la yugular en los pacientes con traumatismo craneoencefálico grave. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 1 | 4 | 5 |
| 2018 March | 0 | 3 | 3 |
| 2018 February | 13 | 12 | 25 |
| 2018 January | 16 | 20 | 36 |
| 2017 December | 17 | 18 | 35 |
| 2017 November | 47 | 31 | 78 |
| 2017 October | 8 | 30 | 38 |
| 2017 September | 10 | 39 | 49 |
| 2017 August | 8 | 34 | 42 |
| 2017 July | 9 | 30 | 39 |
| 2017 June | 24 | 35 | 59 |
| 2017 May | 26 | 41 | 67 |
| 2017 April | 11 | 29 | 40 |
| 2017 March | 17 | 37 | 54 |
| 2017 February | 5 | 33 | 38 |
| 2017 January | 13 | 21 | 34 |
| 2016 December | 22 | 22 | 44 |
| 2016 November | 19 | 37 | 56 |
| 2016 October | 33 | 38 | 71 |
| 2016 September | 59 | 55 | 114 |
| 2016 August | 57 | 46 | 103 |
| 2016 July | 39 | 48 | 87 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 September | 1 | 0 | 1 |
| 2015 August | 1 | 0 | 1 |
| 2015 July | 3 | 7 | 10 |
| 2015 June | 9 | 38 | 47 |
| 2015 May | 10 | 59 | 69 |
| 2015 April | 16 | 59 | 75 |
| 2015 March | 10 | 51 | 61 |
| 2015 February | 11 | 29 | 40 |
| 2015 January | 13 | 28 | 41 |
| 2014 December | 18 | 32 | 50 |
| 2014 November | 10 | 39 | 49 |
| 2014 October | 18 | 59 | 77 |
| 2014 September | 19 | 65 | 84 |
| 2014 August | 17 | 77 | 94 |
| 2014 July | 17 | 47 | 64 |
| 2014 June | 26 | 39 | 65 |
| 2014 May | 26 | 48 | 74 |
| 2014 April | 22 | 44 | 66 |
| 2014 March | 17 | 36 | 53 |
| 2014 February | 23 | 39 | 62 |
| 2014 January | 16 | 32 | 48 |
| 2013 December | 23 | 32 | 55 |
| 2013 November | 14 | 26 | 40 |
| 2013 October | 23 | 44 | 67 |
| 2013 September | 24 | 58 | 82 |
| 2013 August | 23 | 45 | 68 |
| 2013 July | 21 | 60 | 81 |
| 2013 June | 21 | 50 | 71 |
| 2013 May | 23 | 50 | 73 |
| 2013 April | 14 | 38 | 52 |
| 2013 March | 12 | 36 | 48 |
| 2013 February | 6 | 26 | 32 |
| 2013 January | 17 | 16 | 33 |
| 2012 December | 10 | 18 | 28 |
| 2012 November | 0 | 12 | 12 |
| 2012 October | 0 | 1 | 1 |
| 2012 September | 0 | 2 | 2 |
| 2012 January | 9 | 0 | 9 |
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