{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T21:25:34Z","timestamp":1788038734039,"version":"build-2784847793"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR N013433-1"],"award-info":[{"award-number":["MR N013433-1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Gates Cambridge Scholarship"},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["210839"],"award-info":[{"award-number":["210839"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007051","name":"Uppsala University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The primary aim was to explore the association of global cerebral physiological variables including intracranial pressure (ICP), cerebrovascular reactivity (PRx), cerebral perfusion pressure (CPP), and deviation from the PRx-based optimal CPP value (\u2206CPPopt; actual CPP-CPPopt) in relation to brain tissue oxygenation (pbtO<jats:sub>2<\/jats:sub>) in traumatic brain injury (TBI).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 425 TBI patients with ICP- and pbtO<jats:sub>2<\/jats:sub> monitoring for at least 12\u00a0h, who had been treated at the neurocritical care unit, Addenbrooke\u2019s Hospital, Cambridge, UK, between 2002 and 2022 were included. Generalized additive models (GAMs) and linear mixed effect models were used to explore the association of ICP, PRx, CPP, and CPPopt in relation to pbtO<jats:sub>2<\/jats:sub>. PbtO<jats:sub>2<\/jats:sub>\u2009&lt;\u200920\u00a0mmHg, ICP\u2009&gt;\u200920\u00a0mmHg, PRx\u2009&gt;\u20090.30, CPP\u2009&lt;\u200960\u00a0mmHg, and \u2206CPPopt\u2009&lt;\u2009\u2212\u20095\u00a0mmHg were considered as cerebral insults.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>PbtO<jats:sub>2<\/jats:sub>\u2009&lt;\u200920\u00a0mmHg occurred in median during 17% of the monitoring time and in less than 5% in combination with ICP\u2009&gt;\u200920\u00a0mmHg, PRx\u2009&gt;\u20090.30, CPP\u2009&lt;\u200960\u00a0mmHg, or \u2206CPPopt\u2009&lt;\u2009\u2212\u20095\u00a0mmHg. In GAM analyses, pbtO<jats:sub>2<\/jats:sub> remained around 25\u00a0mmHg over a large range of ICP ([0;50] mmHg) and PRx [\u2212\u20091;1], but deteriorated below 20\u00a0mmHg for extremely low CPP below 30\u00a0mmHg and \u2206CPPopt below \u2212\u200930\u00a0mmHg. In linear mixed effect models, ICP, CPP, PRx, and \u2206CPPopt were significantly associated with pbtO<jats:sub>2<\/jats:sub>, but the fixed effects could only explain a very small extent of the pbtO<jats:sub>2<\/jats:sub> variation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>PbtO<jats:sub>2<\/jats:sub> below 20\u00a0mmHg was relatively frequent and often occurred in the absence of disturbances in ICP, PRx, CPP, and \u2206CPPopt. There were significant, but weak associations between the global cerebral physiological variables and pbtO<jats:sub>2<\/jats:sub>, suggesting that hypoxic pbtO<jats:sub>2<\/jats:sub> is often a complex and independent pathophysiological event. Thus, other variables may be more crucial to explain pbtO<jats:sub>2<\/jats:sub> and, likewise, pbtO<jats:sub>2<\/jats:sub> may not be a suitable outcome measure to determine whether global cerebral blood flow optimization such as CPPopt therapy is successful.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13054-023-04627-y","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T12:02:26Z","timestamp":1693483346000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Brain tissue oxygen monitoring in traumatic brain injury: part I\u2014To what extent does PbtO2 reflect global cerebral physiology?"],"prefix":"10.1186","volume":"27","author":[{"given":"Teodor","family":"Svedung Wettervik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erta","family":"Beqiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan Yu","family":"B\u00f6gli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Placek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew R.","family":"Guilfoyle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Helmy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lavinio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronan","family":"O\u2019Leary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Smielewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"4627_CR1","doi-asserted-by":"crossref","first-page":"638132","DOI":"10.3389\/fneur.2021.638132","volume":"12","author":"TM Svedung Wettervik","year":"2021","unstructured":"Svedung Wettervik TM, Lew\u00e9n A, Enblad P. 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