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Review
. 2024 May 17;47(1):222.
doi: 10.1007/s10143-024-02439-4.

Brain tissue oxygen partial pressure monitoring and prognosis of patients with traumatic brain injury: a meta-analysis

Yuqi Shen #  1 , Dan Wen #  1 , Zhenghua Liang #  1 , Li Wan  1 , Qingli Jiang  1 , Haiyan He  1 , Mei He  2
Affiliations
Review

Brain tissue oxygen partial pressure monitoring and prognosis of patients with traumatic brain injury: a meta-analysis

Yuqi Shen et al. Neurosurg Rev. .

Abstract

To assess whether monitoring brain tissue oxygen partial pressure (PbtO2) or employing intracranial pressure (ICP)/cerebral perfusion pressure (CCP)-guided management improves patient outcomes, including mortality, hospital length of stay (LOS), mean daily ICP and mean daily CCP during the intensive care unit(ICU)stay. We searched the Web of Science, EMBASE, PubMed, Cochrane Library, and MEDLINE databases until December 12, 2023. Prospective randomized controlled and cohort studies were included. A meta-analysis was performed for the primary outcome measure, mortality, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eleven studies with a total of 37,492 patients were included. The mortality in the group with PbtO2 was 29.0% (odds ratio: 0.73;95% confidence interval [CI]:0.56-0.96; P = 0.03; I = 55%), demonstrating a significant benefit. The overall hospital LOS was longer in the PbtO2 group than that in the ICP/CPP group (mean difference:2.03; 95% CI:1.03-3.02; P<0.0001; I = 39%). The mean daily ICP in the PbtO2 monitoring group was lower than that in the ICP/CPP group (mean difference:-1.93; 95% CI: -3.61 to -0.24; P = 0.03; I = 41%). Moreover, PbtO2 monitoring did not improve the mean daily CPP (mean difference:2.43; 95%CI: -1.39 to 6.25;P = 0.21; I = 56%).Compared with ICP/CPP monitoring, PbtO2 monitoring reduced the mortality and the mean daily ICP in patients with severe traumatic brain injury; however, no significant effect was noted on the mean daily CPP. In contrast, ICP/CPP monitoring alone was associated with a short hospital stay.

Keywords: Brain tissue oxygen monitoring; Cerebral perfusion pressure; Intracranial pressure; Meta-analysis; Traumatic brain injury.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart
Fig. 2
Fig. 2
Forest plot the effects of PbtO2 monitoring towards mortality
Fig. 3
Fig. 3
Forest plot the effects of PbtO2 monitoring towards overall LOS
Fig. 4
Fig. 4
Forest plot the effects of PbtO2 monitoring towards mean daily ICP during the ICU stay
Fig. 5
Fig. 5
Forest plot the effects of PbtO2 monitoring towards mean daily CPP during the ICU stay
See this image and copyright information in PMC

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