Evidentiary table: SjvO2 monitoring
| Reference | Patient number | Study design | Patient group | Technique assessment | End-point | Findings | Quality of evidence |
|---|---|---|---|---|---|---|---|
| Kiening, 1996 | 15 | Prospective | TBI | SjvO2 and PbtO2 | Quality of data: SjvO2 versus PbtO2 | The ‘‘time of good data quality’’ was 95 % for PbtO2 versus 43 % for SjvO2; PbtO2 monitoring could be performed twice as long as SjvO2 monitoring | Low |
| Meixensberger, 1998 | 55 | Prospective | TBI | SjvO2 and PbtO2 | Quality of data: SjvO2 versus PbtO2 | Analyzing reliability and good data quality, PbtO2 (~95 %) was superior to SjvO2 (~50 %) | Low |
| Robertson, 1989 | 51 | Observational | Mixed (TBI, SAH, stroke) | SjvO2 and PET-scan | Correlation between SjvO2 and CBF | AVDO2 had only a modest correlation with CBF (R = −0.24). When patients with ischemia, indicated by an increased CMRLactate, were excluded from the analysis, CBF and AVDO2 had a much improved correlation (R = −0.74). Most patients with a very low CBF would have been misclassified as having a normal/increased CBF based on AVDO2 | Low |
| Gopinath, 1999 Neurosurgery | 35 | Observational | TBI | SjvO2 and TDP | Correlation between SjvO2 and CBF | When the change in regional CBF was at least 10 mL/100 g/min during ICP elevation, the change of regional CBF reflected the change in SjvO2 on 85 % of the occasions | Low |
| Coles, 2004 | 15 | Prospective | TBI | SjvO2 and PET-scan | Correlation between SjvO2 and CBF | SjvO2 correlated well with the amount of ischemic blood volume (IBV) measured by PET scan (R = 0.8, p < 0.01), however, ischemic SjvO2 values <50 % were only achieved at an IBV of 170 ± 63 mL, which corresponded to an average of 13 % of the brain. Therefore, the sensitivity of SjvO2 monitoring in detecting ischemia was low | Low |
| Keller, 2002 | 10 | Prospective | Large hemispheric stroke | SjvO2 and PETs-can | Correlation between SjvO2 and CBF | Out of 101 ICP/SjvO2, and 92 CBF measurements, only two SjvO2 values were below the ischemic thresholds (SjvO2 < 50 %). SjvO2 did not reflect changes in CBF | Low |
| Fandino, 1999 | 9 | Prospective | TBI | SjvO2 and PbtO2 | Value of SjvO2 versus PbtO2 to predict ischemia | Low correlation between SjvO2 and PbtO2 during CO2-reactivity test: in comparison to SjvO2, PbtO2 is more accurate to detect focal ischemic events | Low |
| Gopinath, 1999 Crit Care Med | 58 | Prospective | TBI | SjvO2 and PbtO2 | Value of SjvO2 versus PbtO2 to predict ischemia | Sensitivities of the two monitors for detecting ischemia were similar | Low |
| Gupta, 1999 | 13 | Prospective | TBI | SjvO2 and PbtO2 | Value of SjvO2 versus PbtO2 to predict ischemia | In areas without focal pathology, good correlation between changes in SjvO2 and PbtO2 (R2 = 0.69, p < 0.0001). In areas with focal pathology, no correlation between SjvO2 and PbtO2 (R2 = 0.07, p = 0.23). PbtO2 reflects regional brain oxygenation better than SjvO2 | Low |
| Robertson, 1998 | 44 | Prospective | TBI | SjvO2 and PbtO2 | Value of SjvO2 versus PbtO2 to predict ischemia | Good correlation in global ischemic episodes; during regional ischemic episodes, only PbtO2 decreased, while SjvO2 did not change | Low |
| De Deyne, 1996 | 150 | Retrospective | TBI | SjvO2 | Detection of ischemia in the early phase (<12 h) | Initial SjvO2 < 50 % in 57 patients (38 %). jugular bulb desaturation was related to CPP < 60 mmHg and PaCO2 < 30 mmHg | Low |
| Vigue, 1999 | 27 | Prospective | TBI | SjvO2 | CPP augmentation with vasopressors and volume resuscitation in the early phase of TBI | Before treatment, 37 % of patients had an SjvO2 < 55 %, and SjvO2 was significantly correlated with CPP (R = 0.73, p < 0.0001). After treatment, we observed a significant increase in CPP (from 53 ± 15 to 78 ± 10 mmHg), MAP (79 ± 9 vs. 103 ± 10 mmHg) and SvjO2 (56 ± 12 vs. 72 ± 7 %), without a significant change in ICP | Low |
| Fortune, 1995 | 22 | Observational | TBI | SjvO2 | ICP therapy | Effective ICP therapy was associated with an improvement in SjvO2 (+2.5 ± 0.7 %) | Low |
| Robertson, 1999 | 189 | RCT | TBI | SjvO2 | Therapy targeted to CBF/ CPP (CPP > 70 mmHg, PaCO2 35 mmHg) versus to ICP (CPP > 50 mmHg, PaCO2 25–30 mmHg) | CBF-targeted protocol reduced the frequency of jugular desaturation from 50.6 to 30 % (p = 0.006); adjusted risk of jugula desaturation 2.4-fold greater with the ICP-targeted protocol. No difference in GOSE score at 6 months. The beneficial effects of the CBF-targeted protocol may have been offset by a fivefold increase in the frequency of adult respiratory distress syndrome | High |