Non-invasive monitoring of cerebral oxygen-saturation in a Jehovah's witness after severe head injury.

Patients with severe head injury run a high risk of developing secondary cerebral defects. Various methods have so far been described which vary in their continuity, invasiveness and technical aspects for the early detection and treatment of complications. Within this group of patients jehovah's witnesses pose a particular problem due to their restriction concerning therapeutical possibilities. That may mean an additional danger to the cerebral O-2-delivery. This case report highlights on the value of continuous, non-invasive cerebral O-2-saturation measurement and its combination with the fiberoptical monitoring of mixed venous O-2-saturation. It has been possible to recognize episodes of imbalance between O-2-delivery and its demand owing to a variety of causes. Other measured parameters were unable to reliably detect the development of critical complications. Further iatrogenic loss of blood by laboratory tests was significantly reduced. Despite partially insufficient circulation and anemia with a hemoglobin value of 49 g/l we were able to discharge the patient from ICU without recognizable neurological sequelae.