Obesity is associated with reduced brain tissue oxygen tension after severe brain injury

Monisha A. Kumar, Rishi Chanderraj, Ryan Gant, Christi Butler, Suzanne Frangos, Eileen Maloney-Wilensky, Jennifer Faerber, W. Andrew Kofke, Joshua M. Levine, Peter LeRoux

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background Obesity has been associated with compromised tissue oxygenation and reduced organ perfusion. The brain is critically dependent on oxygen delivery, and reduced brain tissue oxygen tension (P btO 2) may result in poor outcome after brain injury. We tested the hypothesis that obesity is associated with compromised P btO 2 after severe brain injury. Methods Patients with severe brain injury (GCS score ≤ 8) who underwent continuous P btO 2 monitoring were retrospectively identified from a prospective single-center database. Patients, were classified by body mass index (BMI = weight (kg)/m 2) and were included if they were obese (BMI ≥ 30) or non-obese (BMI = <30). Results Sixty-nine patients (mean age 46.4 ± 17.0 years) were included. Mean daily P btO 2 was 25.8 (9.6) mmHg for the 28 obese and 31.8 (12.3) mmHg for the 41 non-obese patients (P = 0.03). Initial P btO 2 and mean daily maximum P btO 2 measurements also were significantly lower in obese patients than in non-obese patients. Univariate predictors of compromised P btO 2 (defined as minutes P btO 2 < 20 mmHg) included elevated BMI (P = 0.02), presence of ARDS (P < 0.01), mean PaO 2 (P < 0.01), maximum FiO 2 (P < 0.01), mean PaO 2:FiO 2 (P < 0.01), and mean CVP (P < 0.01). In multivariable analysis, BMI was significantly associated with compromised P btO 2 (P = 0.02). Sex, age, and mean CVP were also identified as significant predictors of compromised P btO 2; ARDS and PF ratio were not. Conclusions In patients with severe brain injury, obesity was found to be an independent predictor of compromised P btO 2. This effect may be mediated through obesity-related pulmonary dysfunction and inadequate compensatory mechanisms.

Original languageEnglish (US)
Pages (from-to)286-293
Number of pages8
JournalNeurocritical Care
Issue number2
StatePublished - Apr 2012

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine
  • Clinical Neurology


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