Application of jugular bulb oxygen saturation in the treatment of severe traumatic brain injury / 中国基层医药

ABSTRACT

Objective To investigate the application of jugular bulb oxygen saturation (SjvO2) in the treat-ment of patients with severe traumatic brain injury (sTBI).Methods From August 2016 to August 2017,fifty-three patients with sTBI admitted to intensive care unit ( ICU) of Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences were randomly divided into the intracranial pressure - guided treatment group ( ICP group) and the SjvO2 -guided treatment group (SjvO2 group) by draw lots method.The patients in ICP group ( n=25) were treated according to the routine regimen,and the SjvO2 group (n=28) was dynamically detected SjvO2,and the SjvO2 was maintained at the target range of 55% -75% by adjusting the treatment scheme in addition to the routine treatment regimen.The early GCS score,GOS score and the mortality rate were compared between the two groups three months after injury.Results A total of 36% (9/25) patients had SjvO2 <55% events within 3 days after injury.On the fourth day after injury,the GCS score in the SjvO2 group was better than that in the ICP group [(7.17 ± 1.41)points vs.(6.91 ± 1.10)points,t=1.78,P=0.03],and there was no statistically significant difference in mortality between the two groups at 90 days after injury ( P=0.80).The SjvO2 group had a better prognosis rate compared with ICP group (24.00% vs.10.70% ,χ2 =2.31,P=0.05).Conclusion The treatment strategy of sTBI patients guided by SjvO2 can improve early consciousness level and improve the overall prognosis of sTBI patients.