Current Status of Brain Tissue Oxygen Monitoring in Patients with Traumatic Brain Injury

多重腦部監測系統是目前在神經重症加護單位最重要的功能系統，能夠監測重要的生理參數，包含顱內壓、腦灌流壓、平均動脈壓、動脈氧氣分壓、頸靜脈氧氣濃度和潮氣末二氧化碳壓。對於嚴重創傷性腦損傷病人使用腦組織氧氣分壓監測器可以進一步的提供腦部氧氣傳輸及代謝情形的資訊。腦組織氧氣分壓監測器可偵測腦部氧氣供需與濃度變化，然而目前對於使用腦組織氧氣分壓監測器仍然存在許多爭議：例如最佳使用時機為何？適宜監測部位及使用期限多久？使用後是否真能改善傷者的預後結果？所有的爭議將藉由此篇文獻回顧做一個完整的呈現。從實證醫學的角度證實創傷性腦損傷病人有較高的風險發生續發性腦損傷，使用腦組織氧氣分壓監測器可持續的監測傷者腦部的損傷變化。多重腦部監測系統是安全、便利且高敏感度的診斷工具，同時也能使創傷性腦損傷病人避免出現續發性腦部缺血缺氧的風險，全面降低傷者的死亡率。

關鍵字

腦組織氧氣；顱內壓；創傷性腦損傷；肺功能

並列摘要

Multiple cerebral monitoring system, an essential facility in neurocritical care units, monitors several vital parameters, including intracranial pressure (ICP), cerebral perfusion pressure (CPP), mean arterial pressure (MAP), partial oxygen pressure of artery(PaO_2), jugular vein oxygen saturation(SjvO_2) and end tidal CO_2 pressure (PetCO_2). In addition to these modalities, brain tissue oxygen monitoring is also essential in understanding the oxygen transport and cerebral metabolism in patients with traumatic brain injury. The brain tissue oxygen monitor is a reliable and effective way to measure oxygen supply and demand along with oxygen saturation in the brain. However, many controversial issues remain unsolved, like the best timing to use the monitor and whether all TBI patients should receive monitoring, regardless of their injury severity. There is also no consensus on the optimal site or the duration of monitoring, and whether it improves the prognosis. The present article attempts to discuss these issues in extensive details. From the perspective of evidence-based medicine, all patients who are at risk of disastrous secondary brain injury following the primary traumatic brain injury, are indicated for brain tissue oxygen monitoring. Multiple cerebral monitoring systems, is not only a safe, robust, and highly sensitive diagnostic tool, but can also lower the overall mortality rates by avoiding cerebral ischemia after traumatic brain injury.

並列關鍵字

Brain tissue oxygenation ； Intracranial pressure ； Traumatic brain injury ； Pulmonary function

國際替代計量

Current Status of Brain Tissue Oxygen Monitoring in Patients with Traumatic Brain Injury

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