Jugular Bulb Oxygen Saturation

USES

Jugular Bulb Oxygen Saturation = measure of oxygen delivery and extraction to the brain

  • assess information about cerebral metabolism and blood flow
  • neurosurgery
  • head injury
  • cardiopulmonary bypass

METHOD OF INSERTION AND/OR USE

  • Seldinger technique
  • insert on side of injury
  • retrograde passing of catheter into jugular bulb
  • can measure
  1. venous saturation (goal = 55-85%) – can be measured continuously
  2. PvO2
  3. lactate

OTHER INFORMATION

  • can be attached to a continuous monitor
  • can be inserted unilaterally or bilaterally
  • general use = to optimize blood flow and oxygenation to brain and decrease cerebral metabolic rate

Interpretation

  • hyperemic: > 75%
  • Normal range: 55-75%
  • Critical SjO2: 50-55%
  • Pathological: <50%

Approach to desaturation (< 50%)

  • check accuracy with co-oximetry reading
  • check ABG -> if PO2 low correct
  • check MAP -> if low correct
  • check Hb -> if low correct
  • check ICP -> if high, correct
  • check temperature -> if high, cool
  • check EEG activity to exclude fitting

Approach to Hyperaemia (> 75%)

  • check accuracy with co-oximetry reading
  • if increased CBF contributory -> check PCO2
  • if decreased cerebral oxygen consumption -> check ICP, consider CT

COMPLICATIONS

  • CVL insertion complications
  • only gives information of global cerebral metabolism not regional
  • if both cerebral blood flow and O2 consumption decrease then SjO2 may be unchanged
  • venous thrombosis -> infarction
  • no good data saying that this technique alters outcome

CCC Neurocritical Care Series

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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