Increased brain tissue oxygen tension in children with traumatic brain injury using temperature-corrected guided ventilation during prophylactic hypothermia

Schibler, Andreas and Humphreys, Susan (2012) Increased brain tissue oxygen tension in children with traumatic brain injury using temperature-corrected guided ventilation during prophylactic hypothermia. Critical Care and Resuscitation, 14 1: 20-24.

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Author Schibler, Andreas
Humphreys, Susan
Title Increased brain tissue oxygen tension in children with traumatic brain injury using temperature-corrected guided ventilation during prophylactic hypothermia
Journal name Critical Care and Resuscitation  (ERA 2012 Listed)    (ERA 2010 Rank C)   Check publisher's open access policy
Publication date 2012-03
Sub-type Article
Volume number 14
Issue number 1
ISSN 1441-2772
Start page 20
End page 24
Total pages 5
Place of publication Melbourne, VIC, Australia
Publisher Australasian Academy of Critical Care Medicine
Collection year 2013
Language eng
Formatted abstract Objective: To investigate whether ventilatory management using a temperature-corrected (pH-stat) or uncorrected (alpha-stat) blood gas analysis strategy improves brain tissue oxygen tension (PbrO2) in children prophylactically treated with moderate hypothermia for traumatic brain injury.

Design, setting and participants: Double crossover study conducted in the intensive care unit of a tertiary children’s hospital. Nine children aged 3–14 years with severe traumatic brain injury were randomly allocated twice to a 6-hour period of either alpha- or pH-stat management while being kept hypothermic at 32.5°C.

Main outcome measures: PbrO2, intracranial pressure (ICP) and PbrO2/PaO2.

Results: PbrO2 was significantly higher during pH-stat management (alpha-stat, 23.2mmHg [95% CI, 22.4–24.0mmHg] v pH-stat, 28.7mmHg [95% CI, 27.9–29.5mmHg]; P < 0.001). PbrO2/PaO2 was significantly higher during pH-stat (alpha-stat, 0.190 [95% CI, 0.187–0.193] v pH-stat, 0.251 [95% CI, 0.246–0.259]; P < 0.05). ICP was  non-significantly higher during pH-stat (alpha-stat, 8.8mmHg [95% CI, 8.1–9.5mmHg] v ph-stat,10.2mmHg [95% CI, 9.6–10.8]).

Conclusion: PbrO2 may be improved using a pH-stat blood gas management strategy in prophylactic hypothermia for paediatric patients with traumatic brain injury without any clinically relevant increase in ICP.
Keyword Severe Head Injury
Alpha Stat
Ph Stat
Subarachnoid Hemorrhage
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article
Collections: Official 2013 Collection
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