Možnosti kontinuálního monitoringu průtoku krve mozkem jeho korelace s TCD v detekci vazospasmů u pacientů po těžkém SAK
| Title in English | The possibilities of continuous cerebral blood flow monitoring and its correlation with TCD in detecting of vasospasm in patients after severe SAH |
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| Authors | |
| Year of publication | 2013 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Introduction: Intensive care is as important as early diagnosis and treatment of the aneurysm in terms of prognosis of aneurismal subarachnoid hemorrhage. Higher morbidity and mortality is typical in patients with clinical status corresponding to a greater degree by Hunt and Hess. Multimodal monitoring could allow early detailed assessment of the actual clinical status of such patients and help us to start appropriate therapy in time. Material and Methods: A total of 29 patients corresponding to the clinical status of HH IV + V were enrolled into the study. Due to technical and procedural errors, 17 patients were finally analyzed. The goal was to find the correlation of clinical status, treatment outcome, and levels of tissue oxygen TCD in relation to the direct measurement of cerebral blood flow. The results: In our study group, there was no statistically significant correlation between CBF average values (of the entire monitoring period) and HH grade, Fisher or GOS. The correlation between CBF and Pbt02 varied within a wide range (r = 0.16 to 0.65) in individual cases. In the examined group there was no significant correlation between CBF and flowing TCD parameters: PSV, EDV, Vmean, p = NS for all parameters). Further, in the investigated group there was not a significant correlation between CBF and pulsatility index and resistivity (PI, RI, p = NS), but there was a tendency to indirect correlation between CBF and RI (r = -0.3844, p = 0.0786). Conclusion: Comprehensive monitoring of patients after subarachnoid hemorrhage gives a complex picture about pathologies in the damaged brain tissue and improves intensive treatment. The use of CBF monitoring of the purpose of vasospasm diagnosis is however very limited and cannot be used for this purpose. |