In:
Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, Cambridge University Press (CUP), Vol. 31, No. 1 ( 2004-02), p. 80-86
Abstract:
Cerebral vasospasm adversely impacts the outcome of those suffering aneurysmal subarachnoid hemorrhage (SAH). Prediction of vasospasm could improve outcomes. We hypothesized that preclinical vasospasm would be heralded by an increase in cerebral oxygen extractions (AVDO 2 ) which could be detected by jugular bulb oximetry. A pilot study was conducted to address this hypothesis. Methods: Fourteen consenting patients with aneurysmal SAH, undergoing early surgery, were entered into the study. Four patients were withdrawn from the study secondary to failure of catheters or religious belief. At the time of craniotomy, a jugular bulb catheter was placed. Post-operatively, arterial and jugular bulb blood samples were taken every 12 hours to calculate AVDO 2 . As this was an observational study, no change in management occurred based on measurements. Results: Four of 10 patients had clinical vasospasm. These patients had a significant rise in AVDO 2 approximately one day prior to the onset of neurologic deficits (P 〈 0.001). Symptoms resolved along with a significant improvement in AVDO 2 on instituting hypertensive, hemo-dilutional, and hypervolemic therapy in these patients. The six patients who did not exhibit clinical vasospasm did not demonstrate significant rise in AVDO 2 . Conclusion: Jugular bulb oximetry is simple and cost effective. Increases in AVDO 2 using this technique were predictive of clinically evident vasospasm in the subsequent hours to days. This investigation supports a larger study to assess the utility of jugular bulb oximetry in predicting vasospasm in aneurysmal SAH.
Type of Medium:
Online Resource
ISSN:
0317-1671
,
2057-0155
DOI:
10.1017/S0317167100002870
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2004
detail.hit.zdb_id:
2577275-2
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