In a heterogeneous population of acute brain-injured patients, cerebral multimodal monitoring with intracranial pressure (ICP) and brain tissue oxygen pressure (PbtO2) detected regional cerebral hypoperfusion with a higher accuracy than ICP alone.

Although the absolute values of oxygen ratio (OxR), which was derived from a dynamic hyperoxia test, did not significantly increase the accuracy of ICP and PbtO2 to detect brain hypoperfusion, low OxR might be still useful to identify those patients with low cerebral blood flow (CBF) values despite ICP and PbtO2 values within normal ranges.

87 CTPs were performed in 53 patients.

Cerebral hypoperfusion was observed in 56 (64%) CTPs: ICP, PbtO2 and OxR were significantly different between cerebral computed tomography (CTP) with and without hypoperfusion.

Also, rCBF was correlated with ICP, PbtO2 and OxR.

Compared with ICP alone, monitoring ICP + PbO2 or ICP + PbtO2 + OxR was significantly more accurate in predicting cerebral hypoperfusion.

The accuracy was not significantly different among different etiologies of brain injury.

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