Abstract:
OBJECTIVE:Subarachnoid hemorrhage (SAH) predisposes patients to excessive natriuresis and volume contraction. We studied the effects of postoperative administration of 5% albumin solution on sodium balance and blood volume after SAH. We also sought to identify physiological variables that influence renal sodium excretion after SAH. METHODS:Forty-three patients with acute SAH were randomly assigned to receive hypervolemia or normovolemia treatment for a period of 7 days after aneurysm clipping. In addition to a base line infusion of normal saline solution (80 ml/hr), 250 ml of 5% albumin solution was administered every 2 hours for central venous pressure (CVP) values of < or =8 mm Hg (hypervolemia group, n = 19) or < or =5 mm Hg (normovolemia group, n = 24). RESULTS:Both groups demonstrated relative volume expansion in base line measurements. The hypervolemia group received significantly more total fluid, sodium, and 5% albumin solution than did the normovolemia group and had higher CVP values and serum albumin levels (all P < 0.02). Cumulative sodium balance was even in the hypervolemia group and persistently negative in the normovolemia group, because of sodium losses that occurred on Postoperative Days 2 and 3 (P = 0.03). In a multiple-regression analysis of all patients, 24-hour sodium balance correlated negatively with glomerular filtration rate (GFR) and positively with serum albumin levels, after correction for sodium intake (P < 0.0001). Hypervolemia therapy seemed to paradoxically lower GFR (P = 0.10) and had no effect on blood volume, which declined by 10% in both groups. Pulmonary edema requiring diuresis occurred in only one patient in the hypervolemia group. CONCLUSION:Supplemental 5% albumin solution given to maintain CVP values of >8 mm Hg prevented sodium and fluid losses but did not have an impact on blood volume in our patients, who were hypervolemic in base line measurements. The natriuresis that occurs after SAH may be mediated in part by elevations of GFR. In addition to acting as a colloid volume expander, 5% albumin solution lowers the GFR and promotes renal sodium retention after SAH. These properties may limit the amount of total fluid required to maintain a given CVP value and hence may minimize the frequency of pulmonary edema.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Mayer SA,Solomon RA,Fink ME,Lennihan L,Stern L,Beckford A,Thomas CE,Klebanoff LMdoi
10.1097/00006123-199804000-00048subject
Has Abstractpub_date
1998-04-01 00:00:00pages
759-67; discussion 767-8issue
4eissn
0148-396Xissn
1524-4040journal_volume
42pub_type
临床试验,杂志文章,随机对照试验相关文献
NEUROSURGERY文献大全abstract:BACKGROUND:Several studies have explored the effect of overlapping surgery on patient outcomes, but impact of surgical overlap during wound closure has not been studied. OBJECTIVE:To examine the association of overlap during wound closure and suture time overlap (STO) with patient outcomes in a heterogeneous neurosurg...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1093/neuros/nyz142
更新日期:2019-11-01 00:00:00
abstract::Hydrocephalus without ventriculomegaly and pseudotumor cerebri may present special problems in its treatment. Lumboperitoneal shunting, although frequently effective, is not successful in all cases. A lumbar subarachnoid to venous shunt is described as an alternative to lumboperitoneal shunting. A case illustrating it...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198307000-00015
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:FLOW 800 delivers a color-coded map for snapshot visualization of the temporal distribution dynamics after indocyanine green angiography with post hoc calculation of FLOW 800-specific hemodynamic parameters. However, the value of these parameters regarding quantitative flow assessment remains unclear. OBJEC...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000277
更新日期:2014-06-01 00:00:00
abstract::Glutamate antagonists are the most powerful neuroprotective drugs in laboratory studies of focal cerebral ischemia. Because the majority of clinical conditions in which focal brain ischemia occurs are associated with high intracranial pressure (ICP), we have used the rat acute subdural hematoma model to evaluate the e...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199407000-00016
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To determine whether the Cloward technique of cervical discectomy and fusion increases immediate postoperative stiffness of single cervical motion segment after application of interbody dowel bone graft. METHODS:We measured and compared the stiffness of single-motion segments in cadaveric cervical spines bef...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200112000-00019
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:An intracranial aneurysm is an important acquired cerebrovascular disease that can cause a catastrophic subarachnoid hemorrhage. Despite modern therapy, most patients die or are left disabled as a direct result of a severe initial hemorrhage. The development of more effective treatment strategies depends on u...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199911000-00024
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:Gamma knife stereotactic radiosurgery (GK-SRS) is a safe and noninvasive treatment used as adjuvant therapy for patients with glioblastoma multiforme (GBM). Several studies have yielded conflicting results in the effectiveness of radiosurgery in GBM. This study is a retrospective review of our institutional e...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract::Invading glioma cells seem to follow distinct anatomic structures within the central nervous system. Tumor cell dissemination may occur along structures, such as the basement membranes of blood vessels or the glial limitans externa, that contain extracellular matrix (ECM) proteins. Frequently, invasive glioma cells ar...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199608000-00001
更新日期:1996-08-01 00:00:00
abstract::The development of new devices, especially controlled detachable coils, has made the endovascular approach one of the modalities for the treatment of intracranial aneurysms. We describe the treatment and present the results of 35 patients treated by selective occlusion of basilar artery aneurysms in our department dur...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199605000-00019
更新日期:1996-05-01 00:00:00
abstract::We studied the impairment of autoregulation of cerebral blood flow (CBF) and its effect on the electrical activity of the brain during the development of chronic cerebral vasospasm after subarachnoid hemorrhage, using a vasospasm model in primates. Fourteen animals were divided into two groups: a clot group (8) and a ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199101000-00007
更新日期:1991-01-01 00:00:00
abstract::Traditionally, neurosurgeons have responded to calls to treat new patients or address emergent, acute neurosurgical pathology in the hospitals they staff as part of their duty to the medical profession and community. Due to increasing financial pressures placed upon neurosurgical practice from hospitals and regulatory...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy354
更新日期:2019-04-01 00:00:00
abstract::The management of 15 cases of bilateral locked facets of the cervical spine is reviewed. The C-6, C-7 interspace was the most common interspace involved. There were 4 females and 11 males who were 16 to 63 years old (average, 26 years). Thirteen patients had a complete spinal cord lesion with loss of function below th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198102000-00002
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:It is still debated to what extent intraoperative electrophysiological techniques contribute to the outcome of subthalamic nucleus (STN) deep brain stimulation (DBS). Intraoperative electrophysiological recordings for identification of the STN can be made with one electrode or with multiple, simultaneously im...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/01.neu.0000303993.82149.98
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:Acute recovery from concussion (mild traumatic brain injury) is assessed in samples of NFL and high school athletes evaluated within days of injury. METHODS:All athletes were evaluated within days of injury using a computer-based neuropsychological test and symptom inventory protocol. Test performance was co...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000200272.56192.62
更新日期:2006-02-01 00:00:00
abstract::From December 1981 through August 1984, 24 patients with spinal cord compression syndrome due to epidural neoplasms were evaluated for radiotherapy with clinical examination, radiographs of the spine, and myelography. All plain films were reviewed, and mock radiotherapy fields designed using specific criteria for marg...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198610000-00018
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Spine and nonspine skeletal metastases occur in more than 80% of patients with prostate cancer. OBJECTIVE:To examine the characteristics of the patient population undergoing surgery for the treatment of prostate cancer metastatic to the spine. METHODS:A retrospective chart review was performed on all patie...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyx292
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Preoperative diffusion tensor imaging (DTI) is used to demonstrate corticospinal tract (CST) position. Intraoperative brain shifts may limit preoperative DTI value, and studies characterizing such shifts are lacking. OBJECTIVE:To examine tumor characteristics that could predict intraoperative shift in tumor...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000338
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Surgery for tumors in eloquent brain faces immense challenges when attempting to maximize resection and avoid neurological deficits. OBJECTIVE:In order to give the surgeon real-time atlas-based anatomic information linked to the patient's anatomy, we developed a software-based interface between deformable a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000199
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We describe an alternative surgical technique for treatment of Chiari I malformation associated with ventral compression and instability of the region. An expansive suboccipital cranioplasty and a rigid occipitocervical fixation are performed in one stage. METHODS:The occipitocervical fixation...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000125326.15525.b8
更新日期:2004-06-01 00:00:00
abstract::Eleven athymic nude rats had stereotactic intracerebral inoculation of cells from one of three established human glioma cell lines (A172, A1207, and A1235). The implants grew progressively in 9 of 11 instances, which led to spontaneous death of the host in 14 to 37 days. For comparison, two Sprague-Dawley normal albin...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:A quantitative analysis of intraoperative cortical shift and deformation was performed to gain a better understanding of the nature and extent of this problem and the resultant loss of spatial accuracy in surgical procedures coregistered to preoperative imaging studies. METHODS:Three-dimensional feature trac...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199810000-00010
更新日期:1998-10-01 00:00:00
abstract::We present a case of a patient with two preexisting Silastic syringosubarachnoid shunt catheters who developed Enterobacter meningitis. The infection was treated successfully with systemic and intrathecal antibiotics without removal of the catheters. With careful sequential clinical and laboratory monitoring, even thi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198508000-00015
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:Flow-diverting stents offer a promising treatment option for complex aneurysms. OBJECTIVE:To evaluate the safety and efficacy of the Pipeline embolization device (PED) in the treatment of fusiform and dissecting aneurysms. METHODS:Sixty-five consecutive patients with 69 fusiform and dissecting aneurysms un...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000431
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:Recent findings have cast doubt on vasospasm as the sole cause of delayed cerebral ischemia after subarachnoid hemorrhage. METHODS:We reviewed the medical records of 29 patients who died after subarachnoid hemorrhage. Brain sections were taken from the insula, cingulate gyrus, and hippocampus. Adjacent secti...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000227519.27569.45
更新日期:2006-10-01 00:00:00
abstract::A patient with air gun bullets in the 3rd ventricle associated with delayed ventricular hemorrhage is presented. Through an anterior transcallosal approach, the surgeon successfully removed the bullets without any significant permanent sequelae. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198702000-00022
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Traumatic intraventricular hemorrhage (IVH) can result in association with acute obstructive hydrocephalus, repetitive malfunction of external ventricular drains (EVDs), and uncontrollable increased intracranial pressure. We report a case showing the safe and effective use of intraventricular r...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199810000-00150
更新日期:1998-10-01 00:00:00
abstract::Three cases of intracranial meningioma unmasked by elective general anesthesia are reported. In each case, the meningioma was either asymptomatic or so subtly symptomatic that no suspicion of intracranial tumor had been entertained preoperatively. Each patient presented with failure to wake up after routine general an...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198403000-00012
更新日期:1984-03-01 00:00:00
abstract:STANDARDS:Prophylactic treatment of thromboembolism in patients with severe motor deficits due to spinal cord injury is recommended. The use of low-molecular-weight heparins, rotating beds, adjusted dose heparin, or a combination of modalities is recommended as a prophylactic treatment strategy. Low-dose heparin in com...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-200203001-00014
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Glioblastoma is a heterogeneous disease characterized by its infiltrative growth, rendering complete resection impossible. Diffusion tensor imaging (DTI) shows potential in detecting tumor infiltration by reflecting microstructure disruption. OBJECTIVE:To explore the heterogeneity of glioblastoma infiltrati...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy388
更新日期:2019-10-01 00:00:00
abstract::To improve the localization of stereotactic targets, somatosensory evoked potentials (SEPs) were recorded from the thalamus and subthalamic area using a specially designed semimicroelectrode in 61 patients and a conventional "macroelectrode" in 17 patients. By means of the semimicroelectrode, median nerve stimulation ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199102000-00008
更新日期:1991-02-01 00:00:00