Multimodal Monitoring in Detection and Treatment of Cerebral Ischemia in Patients after Severe Subarachnoid Hemorrhage
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| Year of publication | 2013 |
| Type | Conference abstract |
| MU Faculty or unit | |
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| Description | Introduction : The aim of this study is to evaluate the possibilities and limits of brain tissue oxygen and cerebral blood flow monitoring in patients suffering from severe subarachnoid hemorrhage (SAH). Material and Method : Patients with SAH from a rupture of cerebral vessel aneurysm in clinical status of HH4 and 5 according to Hunt – Hesse classification were enrolled into the study. Brain tissue oxygen monitoring (PbtO2, Licox system) and cerebral blood flow monitoring (CBF, system Hemedex) were performed in addition to standard ICU monitoring. Transcranial dopplermetry (TCD) was performed repeatedly. The correlation between TCD parameters and parameters of PbtO2 and CBF monitoring was evaluated. Results : So far we have enrolled 15 patients, 5 patients were excluded because of failure of both PbtO2 and CBF monitoring. There were 8 females and 2 males in the study group and the mean age was 45,8 years. There were 9 patients in clinical status of HH4 and 1 patient in status of HH5 and the outcome was as follows: GOS 1 (death) – 3 patients, GOS 2 and 3 – 4, GOS 4and 5 – 3 patients. There was significant correlation between PbtO2 values and index of arterial resistivity (p=0. 0288, rs=-0.4464) while there was no correlation between PbtO2 and velocity (p=0. 8527, rs=0. 04001). There was no correlation between parameters of CBF monitoring and TCD. Conclusions : We have found significant correlation between PbtO2 and RI index. RI reflects resistivity of microvasculature. Our results show that PbtO2 monitoring refers to link between PbtO2 values and the condition of microvasculature in the brain. However, we have not found any link between PbtO2 values and TCD velocities which are the main characteristics of vasospasm. |