Abstract:
:Prophylactic use of hypervolemia and hypertension is believed to present an option to decrease the incidence of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and improve neurologic outcome. A Medline literature search was conducted to review available evidence regarding volume management after subarachnoid hemorrhage. Quality of selected studies was evaluated, using the standardized GRADE system. Eleven studies focused on prophylactic hypervolemic therapy after aneurysmal subarachnoid hemorrhage were identified, including four randomized controlled trials. Available studies showed a large heterogeneity in physiologic treatment goals and interventions applied. The oldest and smallest randomized controlled trial suggested a positive effect, but had severe limitations in trial design. Neither of the other randomized controlled studies showed outcome benefit with hypervolemic therapy. Results from observational studies were not found to support the use of prophylactic hypervolemia and hypertension. Complication frequency was repeatedly reported to be higher with the application of prophylactic hypervolemia. In summary, prophylactic hyperdynamic therapy after subarachnoid hemorrhage has not been adequately shown to effectively raise cerebral blood flow or improve neurological outcome. In contrast, there is evidence for harm using overly aggressive hydration.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Wolf S,Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage.doi
10.1007/s12028-011-9593-9subject
Has Abstractpub_date
2011-09-01 00:00:00pages
275-80issue
2eissn
1541-6933issn
1556-0961journal_volume
15pub_type
杂志文章,评审abstract:BACKGROUND:Takotsubo syndrome is a reversible neuromyocardial failure that has been thought to be related to an acute catecholamine toxicity of the myocardium brought upon by a stressful event. The neurocritical care unit population is particularly vulnerable for this condition given the acute presentation of neurologi...
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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