Bedside Technique for the Implantation of Licox Brain Tissue Oxygen Probes in Occipital Regions: A Technical Note

World Neurosurg. 2024 Sep:189:127-131. doi: 10.1016/j.wneu.2024.06.008. Epub 2024 Jun 11.

Abstract

Background: Continuous bedside monitoring of brain tissue oxygen levels is a crucial component in the management of comatose patients suffering from acute brain injury on neurointensive care units. Ensuring sufficient brain oxygenation is recognized as an essential objective within neurocritical care, aimed at safeguarding patients from secondary ischemia. Hypoperfusion in occipital and the posterior watershed regions often remains undetected, as the placement of probes in these areas is challenging. A major concern is that patients would have to lie on the traditionally used implanted bolts due to the occipital entry point of the probes. Therefore, we present a novel technique compatible with magnetic resonance imaging that enables bedside placement of brain tissue oxygen probes without the use of a bolt in these areas.

Methods: We conducted bedside implantations of Licox brain tissue oxygenation probes through Frazier's point utilizing peripheral venous cannulas on burr holes eliminating the need for bolts.

Results: A novel approach was successfully established for the bedside implantation of a Licox brain tissue oxygenation probe for occipital regions.

Conclusions: This technical note describes the feasibility of a novel, simple, and straightforward bedside technique for boltless implantation of Licox brain tissue oxygen probes leading to rigid fixation and compatibility with magnetic resonance imaging.

Keywords: Brain tissue oxygenation; Frazier burr hole; Neuromonitoring; Occipital.

MeSH terms

  • Brain / diagnostic imaging
  • Brain / metabolism
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Occipital Lobe / diagnostic imaging
  • Occipital Lobe / metabolism
  • Oxygen* / metabolism
  • Point-of-Care Systems

Substances

  • Oxygen