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Cerebral oxygenation monitoring 

Cerebral oxygenation monitoring
Chapter:
Cerebral oxygenation monitoring
Author(s):

Matthew A. Kirkman

and Martin Smith

DOI:
10.1093/med/9780198739555.003.0011
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date: 25 June 2019

Cerebral oxygenation monitoring assesses the balance between cerebral oxygen delivery and utilization, and therefore the adequacy of cerebral perfusion. A mismatch between cerebral oxygen supply and demand results in cerebral hypoxia/ischaemia, and is associated with worsened outcome after acute brain injury. Time-critical windows to prevent or minimize permanent ischaemic neurological injury exist but often pass silently because detection of compromise of cerebral oxygenation remains difficult. Methods of monitoring cerebral oxygenation in real time, including jugular venous oxygen saturation, brain tissue oxygen tension, and near-infrared spectroscopy cerebral oximetry, have been developed in an attempt to address this issue. This chapter briefly outlines the physiology and pathophysiology of cerebral oxygenation, and reviews bedside methods of cerebral oxygenation monitoring. Evidence for the utility of cerebral oxygenation-guided therapy is presented, and the chapter ends with a brief discussion of technological advancements that are likely to shape the future of cerebral oxygenation monitoring.

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