Role of brain tissue oxygenation (PbtO2) in the management of subarachnoid haemorrhage: a scoping review protocol

Marco Fiore, Elisa Bogossian, Jacques Creteur, Mauro Oddo, Fabio Silvio Taccone, Marco Fiore, Elisa Bogossian, Jacques Creteur, Mauro Oddo, Fabio Silvio Taccone

Abstract

Introduction: In patients with subarachnoid haemorrhage (SAH), the initial brain oedema and increased blood volume can cause an increase in intracranial pressure (ICP) leading to impaired cerebral perfusion and tissue hypoxia. However, ICP monitoring may not be enough to detect tissue hypoxia, which can also occur in the absence of elevated ICP. Moreover, some patients will experience tissue hypoxia in a later phase after admission due to the occurrence of delayed cerebral ischaemia. Therefore, the measurement of brain oxygenation using invasive techniques has become of great interest. This scoping review seeks to examine the role of brain tissue oxygenation in the management of patients with SAH, mapping the existing literature to identify areas for future research.

Methods and analysis: This scoping review has been planned following the Joanna Briggs Institute recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The literature search will be performed using several databases: Medline, EMBASE, the Cochrane Central Register of Controlled Trials and Grey literature. The database searches are planned from the inception to May 2020. Two reviewers will independently screen titles and abstracts, followed by full-text screening of potentially relevant articles with a standardised data extraction. Articles eligible for the inclusion will be discussed with a third reviewer.

Ethics and dissemination: This paper does not require ethics approval. The results of our evaluation will be disseminated on author's web sites. Additional dissemination will occur through presentations at conferences, such as courses and science education conferences, regionally and nationally, and through articles published in peer-reviewed journals.

Scoping review registration: Open Science Framework Registration: https://doi.org/10.17605/OSF.IO/ZYJ7R.Trial registration numberClinicalTrials.gov Identifier: NCT03754114.

Keywords: adult intensive & critical care; neurology; trauma management.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. Mozaffarian D, Benjamin EJ, Go AS, et al. . Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2015;131:e29–322. 10.1161/CIR.0000000000000152
    1. Connolly ES, Rabinstein AA, Carhuapoma JR, et al. . Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American heart Association/american stroke association. Stroke 2012;43:1711–37. 10.1161/STR.0b013e3182587839
    1. Muehlschlegel S. Subarachnoid hemorrhage. Continuum 2018;24:1623–57. 10.1212/CON.0000000000000679
    1. de Rooij NK, Linn FHH, van der Plas JA, et al. . Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry 2007;78:1365–72. 10.1136/jnnp.2007.117655
    1. Etminan N, Chang H-S, Hackenberg K, et al. . Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis. JAMA Neurol 2019;76:588–97. 10.1001/jamaneurol.2019.0006
    1. Krishnamurthi RV, Feigin VL, Forouzanfar MH, et al. . Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990-2010: findings from the global burden of disease study 2010. Lancet Glob Health 2013;1:e259–81. 10.1016/S2214-109X(13)70089-5
    1. Grote E, Hassler W. The critical first minutes after subarachnoid hemorrhage. Neurosurgery 1988;22:654–61. 10.1227/00006123-198804000-00006
    1. Hayman EG, Wessell A, Gerzanich V, et al. . Mechanisms of global cerebral edema formation in aneurysmal subarachnoid hemorrhage. Neurocrit Care 2017;26:301–10. 10.1007/s12028-016-0354-7
    1. Weimer JM, Jones SE, Frontera JA. Acute cytotoxic and vasogenic edema after subarachnoid hemorrhage: a quantitative MRI study. AJNR Am J Neuroradiol 2017;38:928–34. 10.3174/ajnr.A5181
    1. Fujii M, Yan J, Rolland WB, et al. . Early brain injury, an evolving frontier in subarachnoid hemorrhage research. Transl Stroke Res 2013;4:432–46. 10.1007/s12975-013-0257-2
    1. de Oliveira Manoel AL, Goffi A, Marotta TR, et al. . The critical care management of poor-grade subarachnoid haemorrhage. Crit Care 2016;20:21. 10.1186/s13054-016-1193-9
    1. Chesnut RM. Intracranial pressure monitoring: headstone or a new head start. The best trip trial in perspective. Intensive Care Med 2013;39:771–4. 10.1007/s00134-013-2852-9
    1. Stiefel MF, Udoetuk JD, Spiotta AM, et al. . Conventional neurocritical care and cerebral oxygenation after traumatic brain injury. J Neurosurg 2006;105): :568–75. 10.3171/jns.2006.105.4.568
    1. Stiefel MF, Spiotta A, Gracias VH, et al. . Reduced mortality rate in patients with severe traumatic brain injury treated with brain tissue oxygen monitoring. J Neurosurg 2005;103:805–11. 10.3171/jns.2005.103.5.0805
    1. De Georgia MA. Brain tissue oxygen monitoring in neurocritical care. J Intensive Care Med 2015;30:473–83. 10.1177/0885066614529254
    1. Francoeur CL, Mayer SA. Management of delayed cerebral ischemia after subarachnoid hemorrhage. Crit Care 2016;20:277. 10.1186/s13054-016-1447-6
    1. Proust F, Hannequin D, Langlois O, et al. . Causes of morbidity and mortality after ruptured aneurysm surgery in a series of 230 patients. The importance of control angiography. Stroke 1995;26:1553–7. 10.1161/01.str.26.9.1553
    1. Ropper AH, Zervas NT. Outcome 1 year after SAH from cerebral aneurysm. management morbidity, mortality, and functional status in 112 consecutive good-risk patients. J Neurosurg 1984;60:909–15. 10.3171/jns.1984.60.5.0909
    1. Lee H, et al. Clinical prediction of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage. J Neurosurg 2018:1–8.
    1. Budohoski KP, Guilfoyle M, Helmy A, et al. . The pathophysiology and treatment of delayed cerebral ischaemia following subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 2014;85:1343–53. 10.1136/jnnp-2014-307711
    1. Miller C. Participants in the International multi-disciplinary consensus conference on multimodality, monitoring of cerebral blood flow and ischemia in the critically ill. Neurocrit Care 2014;21:S121–8.
    1. Helbok R, Madineni RC, Schmidt MJ, et al. . Intracerebral monitoring of silent infarcts after subarachnoid hemorrhage. Neurocrit Care 2011;14:162–7. 10.1007/s12028-010-9472-9
    1. Chen HI, Stiefel MF, Oddo M, et al. . Detection of cerebral compromise with multimodality monitoring in patients with subarachnoid hemorrhage. Neurosurgery 2011;69:53–63. 10.1227/NEU.0b013e3182191451
    1. Xie Q, Wu H-B, Yan Y-F, et al. . Mortality and outcome comparison between brain tissue oxygen combined with intracranial Pressure/Cerebral perfusion Pressure-Guided therapy and intracranial Pressure/Cerebral perfusion Pressure-Guided therapy in traumatic brain injury: a meta-analysis. World Neurosurg 2017;100:118–27. 10.1016/j.wneu.2016.12.097
    1. Okonkwo DO, Shutter LA, Moore C, et al. . Brain oxygen optimization in severe traumatic brain injury phase-II: a phase II randomized trial. Crit Care Med 2017;45:1907–14. 10.1097/CCM.0000000000002619
    1. Spiotta AM, Stiefel MF, Gracias VH, et al. . Brain tissue oxygen-directed management and outcome in patients with severe traumatic brain injury. J Neurosurg 2010;113:571–80. 10.3171/2010.1.JNS09506
    1. Narotam PK, Morrison JF, Nathoo N. Brain tissue oxygen monitoring in traumatic brain injury and major trauma: outcome analysis of a brain tissue oxygen-directed therapy. J Neurosurg 2009;111:672–82. 10.3171/2009.4.JNS081150
    1. Aromataris E, Munn Z. Joanna Briggs Institute reviewer's manual. The Joanna Briggs Institute, 2017. Available: [Accessed 28 Feb 2020].
    1. Munn Z, Peters MDJ, Stern C, et al. . Systematic review or scoping review? guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 2018;18:143. 10.1186/s12874-018-0611-x
    1. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005;8:19–32. 10.1080/1364557032000119616
    1. Peters MDJ, Godfrey CM, Khalil H, et al. . Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc 2015;13:141–6. 10.1097/XEB.0000000000000050
    1. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implementation Sci 2010;5:69. 10.1186/1748-5908-5-69
    1. Tricco AC, Lillie E, Zarin W, et al. . PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018;169:467–73. 10.7326/M18-0850
    1. Fiore M, Bogossian E, Taccone FS. The role of brain tissue oxygenation (PbtO2) in the management of subarachnoid hemorrhage: a scoping review protocol. Available: 10.17605/ [Accessed 28 Feb 2020].
    1. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974;2:81–4. 10.1016/s0140-6736(74)91639-0
    1. Frontera JA, Claassen J, Schmidt JM, et al. . Prediction of symptomatic vasospasm after subarachnoid hemorrhage: the modified Fisher scale. Neurosurgery 2006;59:21–7. 10.1227/01.NEU.0000218821.34014.1B
    1. Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 1968;28:14–20. 10.3171/jns.1968.28.1.0014
    1. Report of World Federation of neurological surgeons Committee on a universal subarachnoid hemorrhage grading scale. J Neurosurg 1988;68:985–6. 10.3171/jns.1988.68.6.0985
    1. Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J 2009;26:91–108. 10.1111/j.1471-1842.2009.00848.x

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir