Abstract:
BACKGROUND:The frequency and associations of spontaneous hyperventilation in subarachnoid hemorrhage (SAH) are unknown. Because hyperventilation decreases cerebral blood flow, it may exacerbate delayed cerebral ischemia (DCI) and worsen neurological outcome. METHODS:This is a retrospective analysis of data from a prospectively collected cohort of SAH patients at an academic medical center. Spontaneous hyperventilation was defined by PaCO2 <35 mmHg and pH >7.45 and subdivided into moderate and severe groups. Clinical and demographic characteristics of patients with and without spontaneous hyperventilation were compared using χ (2) or t tests. Bivariate and multivariable logistic regression analyses were conducted to examine the association of moderate and severe hyperventilation with DCI and discharge neurological outcome. RESULTS:Of 207 patients, 113 (55 %) had spontaneous hyperventilation. Spontaneously hyperventilating patients had greater illness severity as measured by the Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), and SAH sum scores. They were also more likely to develop the following complications: pneumonia, neurogenic myocardial injury, systemic inflammatory response syndrome (SIRS), radiographic vasospasm, DCI, and poor neurological outcome. In a multivariable logistic regression model including age, gender, WFNS, SAH sum score, pneumonia, neurogenic myocardial injury, etiology, and SIRS, only moderate [odds ratio (OR) 2.49, 95 % confidence interval (CI) 1.10-5.62] and severe (OR 3.12, 95 % CI 1.30-7.49) spontaneous hyperventilation were associated with DCI. Severe spontaneous hyperventilation (OR 4.52, 95 % CI 1.37-14.89) was also significantly associated with poor discharge outcome in multivariable logistic regression analysis. CONCLUSION:Spontaneous hyperventilation is common in SAH and is associated with DCI and poor neurological outcome.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Williamson CA,Sheehan KM,Tipirneni R,Roark CD,Pandey AS,Thompson BG,Rajajee Vdoi
10.1007/s12028-015-0138-5subject
Has Abstractpub_date
2015-12-01 00:00:00pages
330-8issue
3eissn
1541-6933issn
1556-0961pii
10.1007/s12028-015-0138-5journal_volume
23pub_type
杂志文章abstract:INTRODUCTION:Status epilepticus remains a life-threatening condition that afflicts both adults and children which although occurs in patients with epilepsy, often presents as new-onset seizure activity also. Refractory status epilepticus poses a management challenge for neurological and neurosurgical teams. CASE REPOR...
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pub_type: 临床试验,杂志文章
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更新日期:2007-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析
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