Intracranial pressure and jugular venous oxygenation influence on outcome in patients with severe traumatic brain injury

Different criteria are used to predict outcome of TBI including jugular venous oxygenation (SjvO2) and ICP. However, there is no data on their combined use. ICP measure by ophtalmodynamometry (ODM) of central retinal vein (CR V) never was used for outcome prediction. The aim of the study is to assess the effectiveness of combined use of ICP and SjvO2 measures for outcome prediction in patients with severe TBI. 80 cases of severe TBI with GCS score 8 and lower were studied. In addition to the standard monitoring and intensive therapy SjvO2 and ICP by ODM during acute period of TBI were measured. Positive outcome of acute TBI can be predicted if SjvO2 rate ranges from 55% to 75%. Poor outcome can be predicted if SjvO2 rate is lower than 55%. Patients with normal ICP in this group died from secondary intracranial complications and patients with high ICP died from primary and secondary intracranial injury. Patients with high SjvO2 ( > 75%) also have poor prognostic outcome. The main risks for them are extracerebral complications. It is necessary to use complex monitoring that includes ICP and SjvO2 for accurate prediction of the outcome of TBI. ICP should be measured by minimally invasive method.