Abstract
Background: Normal values of the jugular bulb oxygen saturation were obtained in 1942 and in 1963. Correct catheter positioning was not confirmed radiologically.
Objectives: To replicate the measurements during angiographic catheterisation of the jugular bulb.
Methods: Oxygen saturation in the jugular bulb (SjO2), inferior petrosal sinus (SipsO2), and internal jugular vein was bilaterally measured in 12 patients with Cushing's syndrome undergoing selective bilateral catheterisation of the inferior petrosal sinus. In addition, data from the two old series were reanalysed for comparison.
Results: SjO2 values (44.7%) were significantly lower than in the two old series, particularly concerning the normal lower limit (54.6% and 55.0% respectively). Comparative analysis suggests that contamination with the extracerebral blood of the facial veins and inferior petrosal sinuses was responsible for falsely high SjO2 values in the two old series.
Conclusions: The normal lower SjO2 limit is lower than previously recognised. This may have practical implications for treating severe head trauma patients.
Full Text
The Full Text of this article is available as a PDF (109.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aaslid R., Lindegaard K. F., Sorteberg W., Nornes H. Cerebral autoregulation dynamics in humans. Stroke. 1989 Jan;20(1):45–52. doi: 10.1161/01.str.20.1.45. [DOI] [PubMed] [Google Scholar]
- Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
- Cruz J., Miner M. E., Allen S. J., Alves W. M., Gennarelli T. A. Continuous monitoring of cerebral oxygenation in acute brain injury: injection of mannitol during hyperventilation. J Neurosurg. 1990 Nov;73(5):725–730. doi: 10.3171/jns.1990.73.5.0725. [DOI] [PubMed] [Google Scholar]
- DEIBLER G. E., HOLMES M. S., CAMPBELL P. L., GANS J. Use of triton X-100 as a hemolytic agent in the spectrophotometric measurement of blood O2 saturation. J Appl Physiol. 1959 Jan;14(1):133–136. doi: 10.1152/jappl.1959.14.1.133. [DOI] [PubMed] [Google Scholar]
- Gopinath S. P., Robertson C. S., Contant C. F., Hayes C., Feldman Z., Narayan R. K., Grossman R. G. Jugular venous desaturation and outcome after head injury. J Neurol Neurosurg Psychiatry. 1994 Jun;57(6):717–723. doi: 10.1136/jnnp.57.6.717. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LASSEN N. A., LANE M. H. Validity of internal jugular blood for study of cerebral blood flow and metabolism. J Appl Physiol. 1961 Mar;16:313–320. doi: 10.1152/jappl.1961.16.2.313. [DOI] [PubMed] [Google Scholar]
- Maas A. H., Hamelink M. L., de Leeuw R. J. An evaluation of the spectrophotometric determination of HbO2, and Hb in blood with the co-oximeter IL 182. Clin Chim Acta. 1970 Aug;29(2):303–309. doi: 10.1016/0009-8981(70)90051-3. [DOI] [PubMed] [Google Scholar]
- Macmillan C. S., Andrews P. J. Cerebrovenous oxygen saturation monitoring: practical considerations and clinical relevance. Intensive Care Med. 2000 Aug;26(8):1028–1036. doi: 10.1007/s001340051315. [DOI] [PubMed] [Google Scholar]
- Matta B. F., Lam A. M. The rate of blood withdrawal affects the accuracy of jugular venous bulb. Oxygen saturation measurements. Anesthesiology. 1997 Apr;86(4):806–808. doi: 10.1097/00000542-199704000-00010. [DOI] [PubMed] [Google Scholar]
- Miller D. L., Doppman J. L. Petrosal sinus sampling: technique and rationale. Radiology. 1991 Jan;178(1):37–47. doi: 10.1148/radiology.178.1.1845785. [DOI] [PubMed] [Google Scholar]
- Signorini D. F., Andrews P. J., Jones P. A., Wardlaw J. M., Miller J. D. Adding insult to injury: the prognostic value of early secondary insults for survival after traumatic brain injury. J Neurol Neurosurg Psychiatry. 1999 Jan;66(1):26–31. doi: 10.1136/jnnp.66.1.26. [DOI] [PMC free article] [PubMed] [Google Scholar]