scholarly journals Jugular venous oximetry

2015 ◽  
Vol 02 (03) ◽  
pp. 225-231 ◽  
Author(s):  
Avanish Bhardwaj ◽  
Hemant Bhagat ◽  
Vinod Grover
Keyword(s):  
Cerebral Oxygenation ◽  
Venous Blood ◽  
Jugular Bulb ◽  
Clinical Applications ◽  
Secondary Injury ◽  
Venous Oxygen Saturation ◽  
Metabolic Requirement ◽  
The Brain ◽  
Simple Bedside ◽  
Venous Oximetry

AbstractThe measurement of saturation of venous blood as it drains out of brain by sampling it from the jugular bulb provides us with an estimate of cerebral oxygenation, cerebral blood flow and cerebral metabolic requirement. Arterio-jugular venous difference of the oxygen content (AVDO2) and jugular venous oxygen saturation (SjVO2) values per se helps clinicians in identifying the impairment of cerebral oxygenation due to various factors thereby prompting implementation of corrective measures and the prevention of secondary injury to the brain due to ischaemia. SjVO2 values are also used for prognostication of patients after traumatic brain injury and in other clinical situations. Sampling and measuring SjVO2 intermittently or continuously using fibreoptic oximetry requires the tip of the catheter to be placed in the jugular bulb, which is a relatively simple bedside procedure. In the review below we have discussed the relevant anatomy, physiology, techniques, clinical applications and pitfalls of performing jugular venous oximetry as a tool for measurement of cerebral oxygenation.

scholarly journals Overview of Monitoring of Cerebral Blood Flow and Metabolism after Severe Head Injury

1994 ◽  
Vol 21 (S1) ◽  
pp. S6-S11 ◽  
Author(s):  
J. Paul Muizelaar ◽  
Marc L. Schröder
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Severe Head Injury ◽  
Cerebral Metabolism ◽  
Jugular Bulb ◽  
Cerebral Metabolic Rate ◽  
Venous Oxygen Saturation ◽  
Arteriovenous Difference ◽  
The Brain ◽  
Pressure Autoregulation

AbstractThe relationships between cerebral blood flow (CBF), cerebral metabolism (cerebral metabolic rate of oxygen, CMRO2) and cerebral oxygen extraction (arteriovenous difference of oxygen, AVDO2) are discussed, using the formula CMRO2 = CBF × AVDO2. Metabolic autoregulation, pressure autoregulation and viscosity autoregulation can all be explained by the strong tendency of the brain to keep AVDO2 constant. Monitoring of CBF, CMRO2 or AVDO2 very early after injury is impractical, but the available data indicate that cerebral ischemia plays a considerable role at this stage. It can best be avoided by not "treating" arterial hypertension and not using too much hyperventilation, while generous use of mannitol is probably beneficial. Once in the ICU, treatment can most practically be guided by monitoring of jugular bulb venous oxygen saturation. If saturation drops below 50%, the reason for this must be found (high intracranial pressure, blood pressure not high enough, too vigorous hyperventilation, arterial hypoxia, anemia) and must be treated accordingly.

scholarly journals Preclinical Studies and Translational Applications of Intracerebral Hemorrhage

2017 ◽  
Vol 2017 ◽  
pp. 1-18 ◽  
Author(s):  
Felix Siaw-Debrah ◽  
Mark Nyanzu ◽  
Haoqi Ni ◽  
Xiao Lin ◽  
Zhu Xu ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Conservative Therapy ◽  
Treatment Options ◽  
Disease Process ◽  
Clinical Applications ◽  
Secondary Injury ◽  
Preclinical Studies ◽  
Experimental Drugs ◽  
Disability Rate ◽  
The Brain

Intracerebral hemorrhage (ICH) which refers to bleeding in the brain is a very deleterious condition with high mortality and disability rate. Surgery or conservative therapy remains the treatment option. Various studies have divided the disease process of ICH into primary and secondary injury, for which knowledge into these processes has yielded many preclinical and clinical treatment options. The aim of this review is to highlight some of the new experimental drugs as well as other treatment options like stem cell therapy, rehabilitation, and nanomedicine and mention some translational clinical applications that have been done with these treatment options.

Mixed and central venous oxygen saturation monitoring in the ICU

2016 ◽  
Author(s):  
Frank Bloos ◽  
Konrad Reinhart
Keyword(s):  
Oxygen Saturation ◽  
Superior Vena ◽  
Venous Blood ◽  
Treatment Algorithm ◽  
Vena Cava ◽  
Central Venous Oxygen Saturation ◽  
Whole Body ◽  
Central Venous ◽  
Venous Oxygen Saturation ◽  
Venous Oximetry

Haemodynamic resuscitation should target goals that reflect the tissue oxygen needs of an individual patient. Venous oximetry may be such a tool. Oxygen saturation of blood in the pulmonary artery contains venous blood from the whole body and is referred to as mixed oxygen saturation (SvO2). Measurement of oxygen saturation in blood obtained from a central venous catheter is referred to as central venous oxygen saturation (ScvO2). Both values are not identical since a catheter placed into the superior vena cava only represents venous blood draining the upper body. While it is not possible, in the clinical setting, to predict SvO2 from ScvO2, changes in SvO2 are adequately mirrored by changes in ScvO2. Post-operative patients and patients admitted to intensive care with a low ScvO2 show a higher morbidity and mortality. Early goal-directed therapy (EGDT) combines several haemodynamic goals into a treatment algorithm, including a ScvO2 target. However, recent studies do not support the systematic use of this protocolized approach. A normal value of SvO2 or ScvO2 saturation does not always exclude tissue hypoxia, since it is not possible to identify an inadequate oxygen supply in single organs. A further limitation of this technique is that organ dysfunction can progress, or serum lactate increases, despite normal or even increased venous oximetry values.

Platelet Hyperaggregability in Ischemic Cerebrovascular Disease and Effects of Aspirin

1982 ◽  
Vol 48 (02) ◽  
pp. 117-119 ◽  
Author(s):  
M Kusunoki ◽  
K Kimura ◽  
K Nagatsuka ◽  
Y Isaka ◽  
O Uyama ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Venous Blood ◽  
Second Phase ◽  
Cerebral Angiogram ◽  
Peripheral Venous Blood ◽  
Chronic Stage ◽  
Ischemic Cerebrovascular Disease ◽  
Carotid Arterial ◽  
Platelet Hyperaggregability ◽  
The Brain

SummaryPlatelet aggregation was studied in 24 patients in the chronic stage of ischemic cerebrovascular disease (CVD), with cerebral affluent and effluent blood, i.e., carotid arterial and internal jugular venous blood, and also with peripheral venous blood. Aggregation tests were performed at various final concentrations of sodium arachidonate (A.A.) and ADP. In 17 patients, not taking aspirin, platelet aggregability in jugular venous blood was significantly accentuated compared with that in arterial and peripheral venous blood. This tendency was more marked in the patients with cerebral artery stenosis and/or occlusion than in those with normal cerebral angiogram. In 7 patients taking 500 mg or more oral aspirin, aggregation differences across the brain were not observed and A.A. aggregation and the second phase of ADP aggregation were completely suppressed. These results suggest that a prophylactic administration of aspirin may be beneficial for patients in chronic stage of CVD.

Event-Related Potentials in Psychiatry: Approaches to Research and Clinical Applications

1983 ◽  
Vol 17 (4) ◽  
pp. 307-318 ◽  
Author(s):  
H. G. Stampfer
Keyword(s):  
Information Processing ◽  
Psychiatric Disorders ◽  
Rapid Development ◽  
Event Related Potentials ◽  
Clinical Applications ◽  
Direct Access ◽  
Practical Application ◽  
Clinical Methods ◽  
Related Potentials ◽  
The Brain

This article suggests that the potential usefulness of event-related potentials in psychiatry has not been fully explored because of the limitations of various approaches to research adopted to date, and because the field is still undergoing rapid development. Newer approaches to data acquisition and methods of analysis, combined with closer co-operation between medical and physical scientists, will help to establish the practical application of these signals in psychiatric disorders and assist our understanding of psychophysiological information processing in the brain. Finally, it is suggested that psychiatrists should seek to understand these techniques and the data they generate, since they provide more direct access to measures of complex cerebral processes than current clinical methods.

Cerebral oxygenation and metabolism during exercise following three months of endurance training in healthy overweight males

2009 ◽  
Vol 297 (3) ◽  
pp. R867-R876 ◽  
Author(s):  
T. Seifert ◽  
P. Rasmussen ◽  
P. Brassard ◽  
P. H. Homann ◽  
M. Wissenberg ◽  
...  
Keyword(s):  
Endurance Training ◽  
Cerebral Oxygenation ◽  
Metabolic Response ◽  
Cardiovascular Fitness ◽  
Submaximal Exercise ◽  
Controlled Study ◽  
Venous Catheterization ◽  
The Brain ◽  
Epinephrine Concentration

Endurance training improves muscular and cardiovascular fitness, but the effect on cerebral oxygenation and metabolism remains unknown. We hypothesized that 3 mo of endurance training would reduce cerebral carbohydrate uptake with maintained cerebral oxygenation during submaximal exercise. Healthy overweight males were included in a randomized, controlled study (training: n = 10; control: n = 7). Arterial and internal jugular venous catheterization was used to determine concentration differences for oxygen, glucose, and lactate across the brain and the oxygen-carbohydrate index [molar uptake of oxygen/(glucose + ½ lactate); OCI], changes in mitochondrial oxygen tension (ΔPMitoO2) and the cerebral metabolic rate of oxygen (CMRO2) were calculated. For all subjects, resting OCI was higher at the 3-mo follow-up (6.3 ± 1.3 compared with 4.7 ± 0.9 at baseline, mean ± SD; P < 0.05) and coincided with a lower plasma epinephrine concentration ( P < 0.05). Cerebral adaptations to endurance training manifested when exercising at 70% of maximal oxygen uptake (∼211 W). Before training, both OCI (3.9 ± 0.9) and ΔPMitoO2 (−22 mmHg) decreased ( P < 0.05), whereas CMRO2 increased by 79 ± 53 micromol·100·g−1 min−1 ( P < 0.05). At the 3-mo follow-up, OCI (4.9 ± 1.0) and ΔPMitoO2 (−7 ± 13 mmHg) did not decrease significantly from rest and when compared with values before training ( P < 0.05), CMRO2 did not increase. This study demonstrates that endurance training attenuates the cerebral metabolic response to submaximal exercise, as reflected in a lower carbohydrate uptake and maintaind cerebral oxygenation.

Diagnosis as a Detriment: A Cognitive Approach to Understanding the Depressive Experience

2015 ◽  
Vol 17 (2) ◽  
pp. 125-134 ◽  
Author(s):  
Evan Hy Einstein
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Theoretical Model ◽  
Mental Health Care ◽  
Cognitive Model ◽  
Clinical Applications ◽  
Psychotropic Medications ◽  
Cognitive Mechanisms ◽  
Cognitive Approach ◽  
The Brain

Depression is currently understood within a biomedical paradigm. This paradigm is an example of reductionism; people are clinically diagnosed and categorized based on behavior and affect, while they are then prescribed psychotropic medications based on an inconclusively correlated neurotransmitter imbalance in the brain. In this article, clinical diagnosis and labeling are explored with respect to their detrimental potential. A framework of embodied cognition is used to conceptualize a cognitive model of depressive experience. This theoretical model explores the potentially self-reinforcing cognitive mechanisms behind a depressive experience, with the goal of highlighting the possibility of diagnosis as a detrimental influence on these mechanisms. The aim of this article is to further a discussion about our current mental health care paradigm and provide an explanation as to how it could cause harm to some. Clinical applications of the model are also discussed pertaining to the potential of rendering formal dichotomist diagnoses irrelevant to the ultimate goal of helping people feel better.

Cerebral oxygenation monitoring in patients during and after cardiac arrest -- a narrative review of current methods and evidence

2021 ◽  
Keyword(s):  
Cardiac Arrest ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
The Body ◽  
Narrative Review ◽  
Oxygen Balance ◽  
Monitoring Methods ◽  
Venous Oxygen Saturation ◽  
Oxygenation Monitoring ◽  
The Impact

Hypoxic-ischemic brain injury (HIBI) is a leading cause of mortality in post-cardiac arrest (post-CA) patients who successfully survive the initial cardiopulmonary resuscitation (CPR) but later die in the Intensive Care Unit (ICU). Therefore, a key priority of post-resuscitation ICU care is to prevent and limit the impact of HIBI by optimizing the balance between cerebral oxygen delivery and demand. Traditionally, an optimal systemic oxygen balance is considered to ensure the brain’s oxygen balance. However, the validity of this assumption is uncertain, as the brain constitutes only 2%of the body mass while accounting for approximately 20% of basal oxygen consumption at rest. Hence, there is a real need to monitor cerebral oxygenation realistically. Several imaging and bedside monitoring methods are available for cerebral oxygenation monitoring in post-CA patients. Unfortunately, each of them has its limitations. Imaging methods require transporting a critically ill unstable patient to the scanner. Moreover, they provide an assessment of the oxygenation state only at a particular moment, while brain oxygenation is dynamic. Bedside methods, specifically near-infrared spectroscopy (NIRS), brain tissue oxygen tension (PbtO2), and jugular venous oxygen saturation monitoring (SjvO2), have not often been used in studies involving post-CA patients. Hence there is ambiguity regarding clear recommendations for using these bedside monitors. Presently, the most promising option seems to be using the NIRS as an indicator of effective CPR. We present a narrative review focusing on bedside methods and discuss the evidence for their use in adult patients after cardiac arrest.

Effect of two methods of hand heating on body temperature, forearm blood flow, and deep venous oxygen saturation

1990 ◽  
Vol 259 (5) ◽  
pp. E639-E643 ◽  
Author(s):  
I. W. Gallen ◽  
I. A. Macdonald
Keyword(s):  
Blood Flow ◽  
Body Temperature ◽  
Oxygen Content ◽  
Forearm Blood Flow ◽  
Venous Blood ◽  
Blood Oxygen ◽  
Left Hand ◽  
Venous Oxygen Saturation ◽  
Baseline Values ◽  
Healthy Females

Two methods of hand heating [warmed blanket 40 degrees C (WB) and warm-air box 55 degrees C (WA)] were compared with the effect of no heating (control) in six healthy females. After 30 min baseline, the left hand was either heated for 1 h or not heated. Measurements were made of skin temperature (ST), core temperature (CT), right forearm (FBF) and skin blood flow (SBF), and right forearm deep venous blood oxygen content with and without occlusion of the hand circulation. CT rose above baseline in WB (by +0.2 degrees C, P less than 0.01) but not with control or WA. Abdominal ST rose only with WB (by +0.66 degrees C above baseline, P less than 0.01). FBF increased above baseline values with both WA (by +10 ml.l forearm-1.min-1) and WB (by +12 ml.l forearm-1.min-1), but neither was significantly greater than the control. SBF increased above baseline only with WB (by +202 mV, P less than 0.01), and this was significantly greater than control SBF. With an occluded hand circulation, deep venous oxygen content rose above baseline values with WB only (+6.0%, P less than 0.01) but was not greater than control with either method of hand heating. We conclude that using a warm-air box has less effect than a heated blanket on the measured variables.

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