In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 3 ( 2023-3-21), p. e0283180-
Abstract:
One of the longest-standing treatments to prevent delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH) remains raising the blood pressure to a certain level of mean arterial pressure. This may require high doses of norepinephrine, which has been associated with severe end organ damage. With this study, we aimed to investigate the effects of norepinephrine on the incidence of DCI in a clinical setting. Methods We conducted a retrospective evaluation of patients with aSAH admitted to our institution between November 2018 and March 2021. Potential risk factors for DCI were analyzed and significant predictors were assessed by means of a logistic regression analysis to account for potential confounders. Results In this study, 104 patients were included. Hereof, 39 (38%) showed radiologic signs of DCI between day three and 14 post-intervention. These patients had more frequent vasospasms (n = 37 vs. 30, p = 0.022), a higher Hunt & Hess score (3 ± 2 vs. 2 ± 1, p = 0.004), a lower initial Glasgow Coma Scale score (9 ± 5 vs. 12 ± 4, p = 0.003) and received a higher median norepinephrine dose (20,356μg vs. 6,508μg, p 〈 0.001). A logistic regression analysis revealed that only high-dose norepinephrine administration (OR 2.84, CI 1.56–7.8) and vasospasm (OR 3.07, CI 1.2–7.84) appeared to be significant independent risk factors for DCI. Conclusion Our results indicate a significant association between higher dose norepinephrine administration and the occurrence of DCI. Future research including greater sample sizes and a prospective setting will be necessary to further investigate the relationship.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0283180
DOI:
10.1371/journal.pone.0283180.t001
DOI:
10.1371/journal.pone.0283180.t002
DOI:
10.1371/journal.pone.0283180.t003
DOI:
10.1371/journal.pone.0283180.t004
DOI:
10.1371/journal.pone.0283180.t005
DOI:
10.1371/journal.pone.0283180.s001
DOI:
10.1371/journal.pone.0283180.s002
DOI:
10.1371/journal.pone.0283180.s003
DOI:
10.1371/journal.pone.0283180.r001
DOI:
10.1371/journal.pone.0283180.r002
DOI:
10.1371/journal.pone.0283180.r003
DOI:
10.1371/journal.pone.0283180.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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