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Comparison of a new brain tissue oxygenation measuring probe with the established standard

Introduction

Besides intracranial pressure (ICP) monitoring, brain tissue oxygenation (pbtO2) monitoring with the Licox system (Integra Neuroscience, Germany) is on the verge of clinical routine in acute brain injury. Recently, a new pbtO2 probe by a different manufacturer (Raumedic AG, Germany) was introduced into the market. As this new probe facilitates measurement of ICP as well, its use would reduce invasiveness of multimodal neuromonitoring. Therefore, we investigated the agreement of pbtO2 values of both probes in patients with aneurysmal subarachnoid hemorrhage necessitating ICP and pbtO2 monitoring.

Methods

Eight patients with pbtO2 monitoring probes of both types implanted side by side in the same vascular territory were investigated. Multimodal monitoring data were stored online with dedicated software. Data were analyzed using the method proposed by Bland and Altman [1].

Results

The mean measurement time per patient was 8.6 days. All data pooled, the mean bias was -0.66 mmHg. The precision range (two standard deviations of the bias) was -32.9 to 32.6 mmHg. The Licox probe showed a tendency for higher values at high pbtO2, while the Raumedic probe showed higher values at low pbtO2. Analysis of single patients revealed no discernible pattern in the relationship of measurement values of both probes. Three of the new probes ceased to function prematurely.

Conclusion

Our data suggest that measurements of both pbtO2 probes cannot be interchanged. No easy algorithm for conversion of measurement data from one system to the other is available. More rigorous bench testing is necessary before implementation of the new system in the clinical routine.

References

  1. 1.

    Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986, 1: 307-310.

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Wolf, S., Schürer, L., Horn, P. et al. Comparison of a new brain tissue oxygenation measuring probe with the established standard. Crit Care 13, P90 (2009). https://doi.org/10.1186/cc7254

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Keywords

  • Clinical Routine
  • Aneurysmal Subarachnoid Hemorrhage
  • Acute Brain Injury
  • Discernible Pattern
  • Brain Tissue Oxygenation