Usefulness of venous oxygen saturation in the jugular bulb for the diagnosis of brain death: report of 118 patients

摘要: Abstract Objective. To assess the usefulness of venous oxygen saturation in jugular bulb (SjO2) as a complementary test for diagnosis brain death. Design. Prospective observational study. Setting. Polytrauma intensive care unit (ICU) an acute-care teaching hospital Santander, Spain. Patients. We studied 118 (44%) out 270 patients with severe head injury and intracranial hemorrhage meeting criteria death (lack cardiac response to atropine, unresponsive apnea, iso-electric EEG absence shock, hypotension treatment muscle relaxants and/or central nervous system (CNS) depressant drugs). Measurements results. At moment at which clinical was made obtained, simultaneous blood (right atrium) (SvO2) samples measured. The ratio between SvO2 SjO2, expressed CvjO2 (the so-called venous-jugular rate; = SvO2/SjO2) calculated. less than 1 obtained 114 [mean (SD): 0.89 (0.02)], whereas greater only 4 (3.38%). In group 152 survivors, single patient discharged from ICU vegetative state below 1. showed 96.6% sensitivity, 99.3% specificity, 99.1% 97.4% positive negative predictive values, respectively. Conclusion. Central rate together accepted (unresponsive coma brainstem areflexia) provides non-invasive assessment cerebral circulatory arrest that can help suspect