Neuromonitoring in the intensive care unit. II. Cerebral oxygenation monitoring and microdialysis.

Abstract

Monitoring the injured brain is an integral part of the management of severely brain injured patients in intensive care. There is increasing interest in methods to monitor global and regional cerebral oxygenation. There have been significant advances in analysing tissue oxygenation and local metabolites in the injured brain over the past decade. Cerebral oxygenation can be assessed on a global or regional basis by jugular venous oximetry and near infra-red spectroscopy respectively. Techniques of brain tissue oxygenation monitoring and microdialysis are also covered in this review. Various modalities are available to monitor oxygenation and the local milieu in the injured brain in the intensive care unit. Use of these modalities helps to optimise brain oxygen delivery and metabolism in patients with acute brain injury.