Intraoperative Jugular Desaturation During Surgery for Traumatic Intracranial Hematomas

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Abstract
Traumatic intracranial hematomas which are present on hospital admission or which develop during the hospital course are associated with a worse neurological outcome than diffuse injuries.The purpose of this study was to monitor jugular venous oxygen saturation (SjVO2) during surgery for evacuation of traumatic intracranial mass lesions, to determine the incidence and the causes of jugular venous desaturation, and to assess the usefulness of SjVO2 monitoring in this setting. Twenty-five severely head injured patients were monitored during 27 surgical procedures. At the start of the surgical procedure, the median SjVO2 was 47% (range 25%-89%). Seventeen (63%) of the patients had a SjVO2 less than 50%. Five patients had extremely low SjVO2 values (2 to 65% (range 50%-88%). Intracranial hypertension was the primary cause of the low SjVO2, as confirmed by the response to surgical evacuation. Hypotension (mean arterial pressure 2 might provide useful information about the adequacy of cerebral perfusion. (Anesth Analg 1996;83:1014-21)