The following is the summary of “THE MANTLE” bundle for minimizing cerebral hypoxia in severe traumatic brain injury” published in the January 2023 issue of Critical care by Godoy, et al.

After a severe traumatic lesion to the brain, a steady flow of oxygen is very necessary for neuronal survival. The level of oxygenation of brain tissue reflects the equilibrium between the supply and consumption of oxygen, and it is mostly responsible for determining whether or not cerebral perfusion is adequate. Multiple physiological parameters, such as blood pressure, hemoglobin level, systemic oxygenation, and microcirculation, are responsible for determining the amount of oxygen that is delivered to the brain. 

Additionally, a large number of factors are involved in the delivery of oxygen to its final recipient, which occurs via the respiratory chain. Hypoxia in brain tissue develops when the supply of oxygen is insufficient or when, for some reason, it is unable to be used at the cellular level. There are a variety of factors that might lead to hypoxia, each of which can be investigated using a pathophysiological lens by following “the oxygen route.” Precision medicine, which is tailored and therapeutically geared to the pathophysiology of unique brain injury, is the current direction in the medical industry.

However, to implement this trend, multimodal monitoring must be available. In order to accomplish this goal, researchers came up with the acronym “THE MANTLE,” which refers to a collection of therapeutic interventions that surrounds and safeguards the brain by improving the functioning of the components of the oxygen transport system that run from the surrounding air to the mitochondria.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-022-04242-3