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Arterial-jugular bulb differences in pCO2, lactate, serum sodium and C-reactive protein in neurocritical patients

Introduction

Several reports indicate the potential usefulness of monitoring brain metabolic parameters and their correlation with the system [14]. We want to establish differences and correlation in pCO2, lactate, serum sodium and C-reactive protein (CRP) between arterial and jugular venous bulb blood.

Methods

An observational study. Between 1 January and 31 October 2013 we included neurocritical patients (NCP) with multimodal neuromonitoring (MMN). Daily samples of arterial blood and venous jugular bulb blood were obtained for measuring pCO2, lactate, serum sodium and CRP.

Results

There were 45 NCP, six (13%) with MMN (five men). Mean age was 37 ± 11 years (35 to 61). Diagnostics: two TBI, two SAH, one stroke, one lupus encephalitis. APACHE II was 27 ± 6.5 (25 to 39). Glasgow Coma Scale at admission was 14 ± 4 (4 to 14). pCO2 (mmHg): arterial 41 ± 6.3 versus jugular 45 ± 7.4 (r = 0.7, P = 0.007). Lactate (mg/dl): arterial 11 ± 5.6 versus jugular 13.5 ± 3.9 (r = 0.7, P = 0.9). Sodium (mEq/dl): arterial 141 ± 4.5 versus 141 ± 4.4 (r = 0.8, P = 0.15). CRP (mg/dl): arterial 8 ± 7.4 versus 17 ± 11.6 (r = 0.9, P < 0.001). The correlation and trend curves are shown in Figure 1.

Figure 1
figure 1

abstract P461

Conclusion

A suitable correlation is observed for the arterial-jugular bulb in different variables. There is a significant difference in CRP and pCO2 values being persistently higher in the jugular, particularly for CRP. Studies are required to define its interpretation and potential usefulness.

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Canitrot, M., Ugarte, S. Arterial-jugular bulb differences in pCO2, lactate, serum sodium and C-reactive protein in neurocritical patients. Crit Care 18 (Suppl 1), P460 (2014). https://doi.org/10.1186/cc13650

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  • DOI: https://doi.org/10.1186/cc13650

Keywords

  • Lactate
  • Emergency Medicine
  • Encephalitis
  • Glasgow Coma Scale
  • Potential Usefulness