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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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 1 | 4 | 5 |
| 2018 Marzo | 0 | 3 | 3 |
| 2018 Febrero | 13 | 12 | 25 |
| 2018 Enero | 16 | 20 | 36 |
| 2017 Diciembre | 17 | 18 | 35 |
| 2017 Noviembre | 47 | 31 | 78 |
| 2017 Octubre | 8 | 30 | 38 |
| 2017 Septiembre | 10 | 39 | 49 |
| 2017 Agosto | 8 | 34 | 42 |
| 2017 Julio | 9 | 30 | 39 |
| 2017 Junio | 24 | 35 | 59 |
| 2017 Mayo | 26 | 41 | 67 |
| 2017 Abril | 11 | 29 | 40 |
| 2017 Marzo | 17 | 37 | 54 |
| 2017 Febrero | 5 | 33 | 38 |
| 2017 Enero | 13 | 21 | 34 |
| 2016 Diciembre | 22 | 22 | 44 |
| 2016 Noviembre | 19 | 37 | 56 |
| 2016 Octubre | 33 | 38 | 71 |
| 2016 Septiembre | 59 | 55 | 114 |
| 2016 Agosto | 57 | 46 | 103 |
| 2016 Julio | 39 | 48 | 87 |
| 2016 Marzo | 2 | 0 | 2 |
| 2016 Febrero | 1 | 0 | 1 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Septiembre | 1 | 0 | 1 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 3 | 7 | 10 |
| 2015 Junio | 9 | 38 | 47 |
| 2015 Mayo | 10 | 59 | 69 |
| 2015 Abril | 16 | 59 | 75 |
| 2015 Marzo | 10 | 51 | 61 |
| 2015 Febrero | 11 | 29 | 40 |
| 2015 Enero | 13 | 28 | 41 |
| 2014 Diciembre | 18 | 32 | 50 |
| 2014 Noviembre | 10 | 39 | 49 |
| 2014 Octubre | 18 | 59 | 77 |
| 2014 Septiembre | 19 | 65 | 84 |
| 2014 Agosto | 17 | 77 | 94 |
| 2014 Julio | 17 | 47 | 64 |
| 2014 Junio | 26 | 39 | 65 |
| 2014 Mayo | 26 | 48 | 74 |
| 2014 Abril | 22 | 44 | 66 |
| 2014 Marzo | 17 | 36 | 53 |
| 2014 Febrero | 23 | 39 | 62 |
| 2014 Enero | 16 | 32 | 48 |
| 2013 Diciembre | 23 | 32 | 55 |
| 2013 Noviembre | 14 | 26 | 40 |
| 2013 Octubre | 23 | 44 | 67 |
| 2013 Septiembre | 24 | 58 | 82 |
| 2013 Agosto | 23 | 45 | 68 |
| 2013 Julio | 21 | 60 | 81 |
| 2013 Junio | 21 | 50 | 71 |
| 2013 Mayo | 23 | 50 | 73 |
| 2013 Abril | 14 | 38 | 52 |
| 2013 Marzo | 12 | 36 | 48 |
| 2013 Febrero | 6 | 26 | 32 |
| 2013 Enero | 17 | 16 | 33 |
| 2012 Diciembre | 10 | 18 | 28 |
| 2012 Noviembre | 0 | 12 | 12 |
| 2012 Octubre | 0 | 1 | 1 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 9 | 0 | 9 |
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