PbtO2monitoring in normobaric hyperoxia targeted therapy in acute subarachnoidal hemorrhage

Abstract

Background: Low brain tissue oxygen tension (PbtO2), or brain hypoxia, is an independent predictor of poor outcome. Increasing inspirational fraction of oxygen could have a significant influence on treating lower PbtO2. Combined PbtO2therapy, compared to the approach that focus only on regulation of cerebral perfusion pressure and intracranial pressure, shows better patient outcomes. Monitoring of PbtO2could be helpful in individualizing treatment, preventing or limiting secondary brain injury, and maintaining better patient outcome. Case Description: We present a case of a patient with subarachnoidal hemorrhage to whom PbtO2monitor was implanted, and normobaric hyperoxia treatment was adjusted according to PbtO2measurement. The patient progressively recovered and was dismissed with Glasgow Coma Score 4/5/6. Conclusion: The use of PbtO2monitoring may be useful for monitoring the local tissue values that are useful for induction of normobaric hyperoxia and optimizing the therapy toward more target-defined values. It is an important part of multimodal neuromonitoring, and is the gold standard for brain oxygenation monitoring that can lead to better patient outcome.