Die polarographische messung des sauerstoffpartialdrucks im zerebrovenosen blut zur uberwachung der zerebralen oxygenierung tierexperimentelle und klinische ergebnisse

Translated title of the contribution: Oxygen partial pressure in cerebrovenous blood

M. Menzel, A. Rieger, T. Clausen, S. Roth, J. Soukup, I. Furka, P. Trommler, D. Henze, J. Lindner, J. Radke

Research output: Contribution to journalArticle

Abstract

Background: As technical problems of spectroscopic fiberoptic jugular oxymetry are still present, the aim of this animal study was to explore the feasibility and reliability of continuous monitoring of the oxygen partial pressure (P(cv)O2) in cerebral venous blood during variations of the CPP in an animal intracranial pressure (ICP) model. The above measured parameters were correlated to cerebral perfusion pressure (CPP) and the results of laser Doppler flowmetry (LDF). In a second study in patients, a newly available multisensor probe, which can simultaneously measure oxygen pressure, carbon dioxide pressure, pH, and temperature using a combined electrode-fiberoptic system was evaluated in the bulb of the jugular vein in 8 patients. Materials: Porcine study: The pressure in the infratentorial compartment of 8 domestic pigs under general anesthesia, weighing 18 - 24 kg, was stepwise elevated by inflating a Fogarty balloon catheter, placed up on the infratentorial surface of the right cerebellar hemisphere. The following parameters were continuously monitored: ICP, mean arterial blood pressure (ABP(m)), CPP, P(cv)O2 (polarographic Clark type electrode catheter in the superior sagittal sinus, laser Doppler flowmetry (fiberoptic laser-light catheter, right parietal cortex). Continuously jugular measurement of blood gases: in 8 patients, undergoing craniotomy, a multisensor probe (0.5 mm in diameter) showing a length of the sensor tip of 3.5 cm was inserted in the bulb of the jugular vein. The inspired oxygen ratio (F(i)O(2)) was increased from 0.35 to 1.0. Furthermore hyperventilation was performed by reducing etCO2 by 10 mmHg. Results: Polarographically measured P(cv)O2 exhibited a clear linear correlation to CPP decrease over the whole volume-pressure curve: range for correlation 0.53 to 0.94 in the porcine study. The mean coefficient of correlation (CC) was r(mean) = 0.73. The CC between P(cv)O2 and LDF was r(mean) = 0.83. Testing the functional relation between P(cv)O2 and CPP, we found a coefficient of regression of 0.29 (p <0.001). F(i)O2 challenge: CC(mean) P(cv)O2P(bga)O2=0.98, CC(mean) P(cv)O2-P(cv)CO2=0.92, CC(mean) P(cv)O2-etCO2 = 0.14, CC(mean) P(cv)CO2-P(bga)O2 = 0.8. Hyperventilation: CC(mean) P(cv)O2-etCO2 = 0.91, CC(mean) P(cv)CO2-etCO2 = 0.85. Linear regression between P(cv)O2 and etCO2 during hyperventila- tion showed an (a)R2 = 0.96 (p <0.001). Conclusion: P(cv)O2 monitoring significantly represents changes of the CPP beyond the lower threshold of autoregulation related to ICP rise. The method was judged as an sufficiently representative method, which was not affected by light artefacts and/or low blood flow velocity during increased ICP. Measuring the physically dissolved oxygen in the jugular venous blood in patients showed a reliable measuring performance though we did not attempt for in vivo calibration. A major disadvantage of the currently available multisensor probe is the length of the tip of the sensor that makes in vivo calibration in the bulb of jugular vein insufficient. The ability to measure cerebrovenous oxygenation as well as P(cv)CO2 and pH status of the patients will improve the understanding of these parameters in both normal and pathological states. Statement: Measuring the physically dissolved oxygen in the cerebral venous blood successfully attempts at overcoming difficulties in clinical cerebral venous oxymetry by fiberoptic systems.

Original languageGerman
Pages (from-to)132-142
Number of pages11
JournalIntensiv- und Notfallbehandlung
Volume23
Issue number3
Publication statusPublished - 1998

Fingerprint

Cerebrovascular Circulation
Partial Pressure
Intracranial Pressure
Oxygen
Laser-Doppler Flowmetry
Hyperventilation
Jugular Veins
Pressure
Neck
Catheters
Calibration
Arterial Pressure
Electrodes
Swine
Superior Sagittal Sinus
Light
Sus scrofa
Parietal Lobe
Blood Flow Velocity
Craniotomy

Keywords

  • Brain
  • Carbondioxide pressure
  • Intracranial pressure
  • Jugular bulb
  • Laser Doppler flowmetry
  • Oxygen partial pressure
  • Paratrend 7

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Die polarographische messung des sauerstoffpartialdrucks im zerebrovenosen blut zur uberwachung der zerebralen oxygenierung tierexperimentelle und klinische ergebnisse. / Menzel, M.; Rieger, A.; Clausen, T.; Roth, S.; Soukup, J.; Furka, I.; Trommler, P.; Henze, D.; Lindner, J.; Radke, J.

In: Intensiv- und Notfallbehandlung, Vol. 23, No. 3, 1998, p. 132-142.

Research output: Contribution to journalArticle

Menzel, M, Rieger, A, Clausen, T, Roth, S, Soukup, J, Furka, I, Trommler, P, Henze, D, Lindner, J & Radke, J 1998, 'Die polarographische messung des sauerstoffpartialdrucks im zerebrovenosen blut zur uberwachung der zerebralen oxygenierung tierexperimentelle und klinische ergebnisse', Intensiv- und Notfallbehandlung, vol. 23, no. 3, pp. 132-142.
Menzel, M. ; Rieger, A. ; Clausen, T. ; Roth, S. ; Soukup, J. ; Furka, I. ; Trommler, P. ; Henze, D. ; Lindner, J. ; Radke, J. / Die polarographische messung des sauerstoffpartialdrucks im zerebrovenosen blut zur uberwachung der zerebralen oxygenierung tierexperimentelle und klinische ergebnisse. In: Intensiv- und Notfallbehandlung. 1998 ; Vol. 23, No. 3. pp. 132-142.
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title = "Die polarographische messung des sauerstoffpartialdrucks im zerebrovenosen blut zur uberwachung der zerebralen oxygenierung tierexperimentelle und klinische ergebnisse",
abstract = "Background: As technical problems of spectroscopic fiberoptic jugular oxymetry are still present, the aim of this animal study was to explore the feasibility and reliability of continuous monitoring of the oxygen partial pressure (P(cv)O2) in cerebral venous blood during variations of the CPP in an animal intracranial pressure (ICP) model. The above measured parameters were correlated to cerebral perfusion pressure (CPP) and the results of laser Doppler flowmetry (LDF). In a second study in patients, a newly available multisensor probe, which can simultaneously measure oxygen pressure, carbon dioxide pressure, pH, and temperature using a combined electrode-fiberoptic system was evaluated in the bulb of the jugular vein in 8 patients. Materials: Porcine study: The pressure in the infratentorial compartment of 8 domestic pigs under general anesthesia, weighing 18 - 24 kg, was stepwise elevated by inflating a Fogarty balloon catheter, placed up on the infratentorial surface of the right cerebellar hemisphere. The following parameters were continuously monitored: ICP, mean arterial blood pressure (ABP(m)), CPP, P(cv)O2 (polarographic Clark type electrode catheter in the superior sagittal sinus, laser Doppler flowmetry (fiberoptic laser-light catheter, right parietal cortex). Continuously jugular measurement of blood gases: in 8 patients, undergoing craniotomy, a multisensor probe (0.5 mm in diameter) showing a length of the sensor tip of 3.5 cm was inserted in the bulb of the jugular vein. The inspired oxygen ratio (F(i)O(2)) was increased from 0.35 to 1.0. Furthermore hyperventilation was performed by reducing etCO2 by 10 mmHg. Results: Polarographically measured P(cv)O2 exhibited a clear linear correlation to CPP decrease over the whole volume-pressure curve: range for correlation 0.53 to 0.94 in the porcine study. The mean coefficient of correlation (CC) was r(mean) = 0.73. The CC between P(cv)O2 and LDF was r(mean) = 0.83. Testing the functional relation between P(cv)O2 and CPP, we found a coefficient of regression of 0.29 (p <0.001). F(i)O2 challenge: CC(mean) P(cv)O2P(bga)O2=0.98, CC(mean) P(cv)O2-P(cv)CO2=0.92, CC(mean) P(cv)O2-etCO2 = 0.14, CC(mean) P(cv)CO2-P(bga)O2 = 0.8. Hyperventilation: CC(mean) P(cv)O2-etCO2 = 0.91, CC(mean) P(cv)CO2-etCO2 = 0.85. Linear regression between P(cv)O2 and etCO2 during hyperventila- tion showed an (a)R2 = 0.96 (p <0.001). Conclusion: P(cv)O2 monitoring significantly represents changes of the CPP beyond the lower threshold of autoregulation related to ICP rise. The method was judged as an sufficiently representative method, which was not affected by light artefacts and/or low blood flow velocity during increased ICP. Measuring the physically dissolved oxygen in the jugular venous blood in patients showed a reliable measuring performance though we did not attempt for in vivo calibration. A major disadvantage of the currently available multisensor probe is the length of the tip of the sensor that makes in vivo calibration in the bulb of jugular vein insufficient. The ability to measure cerebrovenous oxygenation as well as P(cv)CO2 and pH status of the patients will improve the understanding of these parameters in both normal and pathological states. Statement: Measuring the physically dissolved oxygen in the cerebral venous blood successfully attempts at overcoming difficulties in clinical cerebral venous oxymetry by fiberoptic systems.",
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author = "M. Menzel and A. Rieger and T. Clausen and S. Roth and J. Soukup and I. Furka and P. Trommler and D. Henze and J. Lindner and J. Radke",
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T1 - Die polarographische messung des sauerstoffpartialdrucks im zerebrovenosen blut zur uberwachung der zerebralen oxygenierung tierexperimentelle und klinische ergebnisse

AU - Menzel, M.

AU - Rieger, A.

AU - Clausen, T.

AU - Roth, S.

AU - Soukup, J.

AU - Furka, I.

AU - Trommler, P.

AU - Henze, D.

AU - Lindner, J.

AU - Radke, J.

PY - 1998

Y1 - 1998

N2 - Background: As technical problems of spectroscopic fiberoptic jugular oxymetry are still present, the aim of this animal study was to explore the feasibility and reliability of continuous monitoring of the oxygen partial pressure (P(cv)O2) in cerebral venous blood during variations of the CPP in an animal intracranial pressure (ICP) model. The above measured parameters were correlated to cerebral perfusion pressure (CPP) and the results of laser Doppler flowmetry (LDF). In a second study in patients, a newly available multisensor probe, which can simultaneously measure oxygen pressure, carbon dioxide pressure, pH, and temperature using a combined electrode-fiberoptic system was evaluated in the bulb of the jugular vein in 8 patients. Materials: Porcine study: The pressure in the infratentorial compartment of 8 domestic pigs under general anesthesia, weighing 18 - 24 kg, was stepwise elevated by inflating a Fogarty balloon catheter, placed up on the infratentorial surface of the right cerebellar hemisphere. The following parameters were continuously monitored: ICP, mean arterial blood pressure (ABP(m)), CPP, P(cv)O2 (polarographic Clark type electrode catheter in the superior sagittal sinus, laser Doppler flowmetry (fiberoptic laser-light catheter, right parietal cortex). Continuously jugular measurement of blood gases: in 8 patients, undergoing craniotomy, a multisensor probe (0.5 mm in diameter) showing a length of the sensor tip of 3.5 cm was inserted in the bulb of the jugular vein. The inspired oxygen ratio (F(i)O(2)) was increased from 0.35 to 1.0. Furthermore hyperventilation was performed by reducing etCO2 by 10 mmHg. Results: Polarographically measured P(cv)O2 exhibited a clear linear correlation to CPP decrease over the whole volume-pressure curve: range for correlation 0.53 to 0.94 in the porcine study. The mean coefficient of correlation (CC) was r(mean) = 0.73. The CC between P(cv)O2 and LDF was r(mean) = 0.83. Testing the functional relation between P(cv)O2 and CPP, we found a coefficient of regression of 0.29 (p <0.001). F(i)O2 challenge: CC(mean) P(cv)O2P(bga)O2=0.98, CC(mean) P(cv)O2-P(cv)CO2=0.92, CC(mean) P(cv)O2-etCO2 = 0.14, CC(mean) P(cv)CO2-P(bga)O2 = 0.8. Hyperventilation: CC(mean) P(cv)O2-etCO2 = 0.91, CC(mean) P(cv)CO2-etCO2 = 0.85. Linear regression between P(cv)O2 and etCO2 during hyperventila- tion showed an (a)R2 = 0.96 (p <0.001). Conclusion: P(cv)O2 monitoring significantly represents changes of the CPP beyond the lower threshold of autoregulation related to ICP rise. The method was judged as an sufficiently representative method, which was not affected by light artefacts and/or low blood flow velocity during increased ICP. Measuring the physically dissolved oxygen in the jugular venous blood in patients showed a reliable measuring performance though we did not attempt for in vivo calibration. A major disadvantage of the currently available multisensor probe is the length of the tip of the sensor that makes in vivo calibration in the bulb of jugular vein insufficient. The ability to measure cerebrovenous oxygenation as well as P(cv)CO2 and pH status of the patients will improve the understanding of these parameters in both normal and pathological states. Statement: Measuring the physically dissolved oxygen in the cerebral venous blood successfully attempts at overcoming difficulties in clinical cerebral venous oxymetry by fiberoptic systems.

AB - Background: As technical problems of spectroscopic fiberoptic jugular oxymetry are still present, the aim of this animal study was to explore the feasibility and reliability of continuous monitoring of the oxygen partial pressure (P(cv)O2) in cerebral venous blood during variations of the CPP in an animal intracranial pressure (ICP) model. The above measured parameters were correlated to cerebral perfusion pressure (CPP) and the results of laser Doppler flowmetry (LDF). In a second study in patients, a newly available multisensor probe, which can simultaneously measure oxygen pressure, carbon dioxide pressure, pH, and temperature using a combined electrode-fiberoptic system was evaluated in the bulb of the jugular vein in 8 patients. Materials: Porcine study: The pressure in the infratentorial compartment of 8 domestic pigs under general anesthesia, weighing 18 - 24 kg, was stepwise elevated by inflating a Fogarty balloon catheter, placed up on the infratentorial surface of the right cerebellar hemisphere. The following parameters were continuously monitored: ICP, mean arterial blood pressure (ABP(m)), CPP, P(cv)O2 (polarographic Clark type electrode catheter in the superior sagittal sinus, laser Doppler flowmetry (fiberoptic laser-light catheter, right parietal cortex). Continuously jugular measurement of blood gases: in 8 patients, undergoing craniotomy, a multisensor probe (0.5 mm in diameter) showing a length of the sensor tip of 3.5 cm was inserted in the bulb of the jugular vein. The inspired oxygen ratio (F(i)O(2)) was increased from 0.35 to 1.0. Furthermore hyperventilation was performed by reducing etCO2 by 10 mmHg. Results: Polarographically measured P(cv)O2 exhibited a clear linear correlation to CPP decrease over the whole volume-pressure curve: range for correlation 0.53 to 0.94 in the porcine study. The mean coefficient of correlation (CC) was r(mean) = 0.73. The CC between P(cv)O2 and LDF was r(mean) = 0.83. Testing the functional relation between P(cv)O2 and CPP, we found a coefficient of regression of 0.29 (p <0.001). F(i)O2 challenge: CC(mean) P(cv)O2P(bga)O2=0.98, CC(mean) P(cv)O2-P(cv)CO2=0.92, CC(mean) P(cv)O2-etCO2 = 0.14, CC(mean) P(cv)CO2-P(bga)O2 = 0.8. Hyperventilation: CC(mean) P(cv)O2-etCO2 = 0.91, CC(mean) P(cv)CO2-etCO2 = 0.85. Linear regression between P(cv)O2 and etCO2 during hyperventila- tion showed an (a)R2 = 0.96 (p <0.001). Conclusion: P(cv)O2 monitoring significantly represents changes of the CPP beyond the lower threshold of autoregulation related to ICP rise. The method was judged as an sufficiently representative method, which was not affected by light artefacts and/or low blood flow velocity during increased ICP. Measuring the physically dissolved oxygen in the jugular venous blood in patients showed a reliable measuring performance though we did not attempt for in vivo calibration. A major disadvantage of the currently available multisensor probe is the length of the tip of the sensor that makes in vivo calibration in the bulb of jugular vein insufficient. The ability to measure cerebrovenous oxygenation as well as P(cv)CO2 and pH status of the patients will improve the understanding of these parameters in both normal and pathological states. Statement: Measuring the physically dissolved oxygen in the cerebral venous blood successfully attempts at overcoming difficulties in clinical cerebral venous oxymetry by fiberoptic systems.

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