Microvascular cerebral blood flow response to intrathecal nicardipine is associated with delayed cerebral ischemia.
Microvascular cerebral blood flow response to intrathecal nicardipine is associated with delayed cerebral ischemia.
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DOI：
10.3389/fneur.2023.1052232
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发表时间：
2023
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
非创伤性蛛网膜下腔出血（SAH）的常见并发症之一是迟发性脑缺血（DCI）。在检测到大动脉脑血管痉挛后，鞘内（IT）给予尼卡地平（一种钙通道阻滞剂（CCB））有望成为降低DCI发生率的治疗方法。在这项观察性研究中，我们前瞻性地采用了一种称为弥散相关光谱（DCS）的非侵入性光学模式，以量化20例中高度非创伤性SAH患者对IT尼卡地平（长达90分钟）的急性微血管脑血流（CBF）反应。平均而言，CBF随给药后时间显著增加。然而，受试者之间的CBF反应是异质的。潜在类别混合模型能够将20例患者中的19例分为两种不同的CBF反应类别：1类患者（n = 6）的CBF无显著变化，而2类患者（n = 13）的CBF对尼卡地平的反应明显增加。DCI的发生率在1级中为6例中的5例，在2级中为13例中的1例（p < 0.001）。这些结果表明，DCS测量的CBF对IT尼卡地平的急性（<90分钟）反应与DCI的中期（长达3周）发展相关。
One of the common complications of non-traumatic subarachnoid hemorrhage (SAH) is delayed cerebral ischemia (DCI). Intrathecal (IT) administration of nicardipine, a calcium channel blocker (CCB), upon detection of large-artery cerebral vasospasm holds promise as a treatment that reduces the incidence of DCI. In this observational study, we prospectively employed a non-invasive optical modality called diffuse correlation spectroscopy (DCS) to quantify the acute microvascular cerebral blood flow (CBF) response to IT nicardipine (up to 90 min) in 20 patients with medium-high grade non-traumatic SAH. On average, CBF increased significantly with time post-administration. However, the CBF response was heterogeneous across subjects. A latent class mixture model was able to classify 19 out of 20 patients into two distinct classes of CBF response: patients in Class 1 (n = 6) showed no significant change in CBF, while patients in Class 2 (n = 13) showed a pronounced increase in CBF in response to nicardipine. The incidence of DCI was 5 out of 6 in Class 1 and 1 out of 13 in Class 2 (p < 0.001). These results suggest that the acute (<90 min) DCS-measured CBF response to IT nicardipine is associated with intermediate-term (up to 3 weeks) development of DCI.
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影响因子：
8.3
作者：
BISHOP, CCR;POWELL, S;BROWSE, NL
通讯作者：
BROWSE, NL
DOI：
10.1364/josaa.11.002727
发表时间：
1994-10-01
影响因子：
1.9
作者：
HASKELL, RC;SVAASAND, LO;TROMBERG, BJ
通讯作者：
TROMBERG, BJ
影响因子：
4.8
作者：
PASQUALIN, A;VOLLMER, DG;TORNER, JC
通讯作者：
TORNER, JC
影响因子：
--
作者：
Naraoka M;Matsuda N;Shimamura N;Asano K;Ohkuma H
通讯作者：
Ohkuma H
影响因子：
8.3
作者：
Frontera, Jennifer A.;Fernandez, Andres;Mayer, Stephan A.
通讯作者：
Mayer, Stephan A.