Severe head injury and jugular bulb venous oxygen saturation monitoring: A pilot study

We evaluated the efficiency of continuous monitoring of oxyhaemoglobin saturation (SaO₂) in the jugular bulb in order to determine its utility in the monitoring and treatment of patients with severe head injury (HI). Sixty-four patients with HI and a Glasgow coma score ≤8 were included in this study. On admission to the intensive care unit, an Opticath® catheter (Abbott Laboratories, North Chicago, IL, USA) was inserted in the right jugular bulb. The maximum jugular venous SaO₂ (SjO₂) was: 91 (10)(*) for the 36 survivors, 78 (32) for the six vegetative coma patients and 97 (8)(*) for the 22 patients found to be brain dead ((*)p = 0.0009). The minimum SjO₂ was: 55 (13)(*) for the survivors, 36 (29)(*)/(**) for the vegetative coma patients ((*)p = 0.001) and 59 (39)(**) for the brain-dead patients ((**)p = 0.01). We conclude that falls in SjO₂ may influence the management of HI patients and may help to detect evolution to cerebral ischaemia in these patients. The inclusion of several variables in a logistic regression analysis allows outcome prediction in 95% of these patients.