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Vol. 31. Issue 1.
Pages 24-36 (January - February 2020)
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Vol. 31. Issue 1.
Pages 24-36 (January - February 2020)
Special article
DOI: 10.1016/j.neucie.2019.08.002
International consensus on the monitoring of cerebral oxygen tissue pressure in neurocritical patients
Consenso internacional sobre la monitorización de la presión tisular cerebral de oxígeno en pacientes neurocríticos
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José María Domínguez-Roldána,b,c,
Corresponding author
jmdominguez@telefonica.net

Corresponding author.
, Santiago Lubillob,d, Walter Videttaa,e, Juan Antonio Llompart-Poua,f, Rafael Badenesa,g, Javier Márquez Rivasb,h, Javier Ibáñezf,h, Daniel A. Godoya,i, Francisco Murillo-Cabezasa,b,c, Grupo de expertos en la monitorización del paciente neurológico crítico , Jurado del Consenso
a Servicio de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, España
b Servicio de Medicina Intensiva, Hospital Universitario Virgen del Rocío, Sevilla, España
c Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
d Servicio de Medicina Intensiva, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
e Unidad de Cuidados Intensivos, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
f Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Spain
g Departamento de Anestesiología y Cuidados Intensivos, Hospital Clínic Universitari, Valencia, Spain
h Servicio de Neurocirugía, Hospital Universitario Virgen del Rocío, Sevilla, Spain
i Unidad de Cuidados Neurocríticos, Hospital San Juan Bautista, y Sanatorio Pasteur, Catamarca, Argentina
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Table 1. Types of cerebral hypoxia based on the Sigaard-Andersen classification.
Table 2. Types of hypoxia detected with PtiO2 monitoring.
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Abstract

Continuous monitoring of cerebral oxygenation and its application to the management of the severe neurological patient is a challenge for the management of patients with acute critical brain damage. Although several techniques have been described for monitoring brain, brain tissue oxygen monitoring provides relevant information about oxygen levels of brain tissue. However, the development of this technique has been associated with the need to answer not only some technical aspects of it as well as the meaning of the changes of the cerebral oxygenation in the neurocritical patient. The consensus document responds to various questions related to the monitoring of cerebral oxygenation by means of a cerebral oxygen tissue pressure sensor. For this purpose, a list of questions was prepared and a reviewed of the medical literature was made. The quality of the evidence and the degree of recommendation was evaluated using the GRADE methodology.

Keywords:
Brain tissue oxygenation
Cerebral tissue oxygen pressure
Traumatic Brain Injury
Subarachnoid hemorrhage
Resumen

La monitorización continua de la oxigenación cerebral y su aplicación al manejo del paciente neurológico grave es uno de los grandes retos actuales de la medicina crítica. Aunque han sido descritas diversas técnicas para la monitorización de la oxigenación cerebral, la monitorización tisular cerebral de oxígeno proporciona una relevante información sobre los niveles de oxígeno a nivel del tejido cerebral. Su desarrollo se ha asociado a la necesidad de responder no solamente aspectos técnicos sobre la misma, sino también al significado de la alteración de los valores de la oxigenación cerebral en el paciente neurocrítico. El documento de consenso da respuesta a diversas cuestiones relativas a la monitorización de la oxigenación cerebral mediante sensor de presión tisular cerebral de oxígeno. Para ello se elaboró un panel de preguntas y se realizó una revisión de la literatura médica, y evaluando la calidad de la evidencia y el nivel de recomendación mediante la metodología GRADE.

Palabras clave:
Oxigenación tisular cerebral
Presión tisular cerebral de oxígeno
Traumatismo craneoencefálico
Hemorragia subaracnoidea

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