CEREBRAL BLOOD FLOW AFTER SUBARACHNOID HEMORRHAGE

蛛网膜下腔出血后的脑血流

• 批准号: 3413581
• 负责人: ROBERT A SOLOMON
• 金额: $ 30.66万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-02-01 至 1995-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3413581
• 关键词: blood volume; brain disorder chemotherapy; cardiac output; human subject; human therapy evaluation; hypervolemia; neurosurgery; nicardipine; subarachnoid hemorrhage; subarachnoid space; vasospasm

DESCRIPTION: (Investigator's Abstract) Following the rupture of an intracranial aneurysm, a devasting complication is the development of delayed cerebral ischemia due to vasospasm. Clinical investigations have demonstrated that prophylactic intravascular volume expansion may reduce the incidence of delayed cerebral ischemia after subarachnoid hemorrhage (SAH), presumably by improving cerebral blood flow (CBF). However, the relationship of the therapy to changes in CBF has not been adequately determined. This proposal is a clinical physiological study comparing CBF during hypervolemia and normovolemic therapy within the first 2 weeks after aneurysmal SAH. Hemodilution will be the same for both groups. The effect of these two treatments as well as cardiac output, hematocrit, blood pressure, and blood volume on CBF will be determined. A secondary assessment will be made of the change in CBF after institution of hypertensive hypervolemia therapy for delayed cerebral ischemia in both normovolemic and hypervolemia subjects. The sensitivity and specificity of transcranial doppler (TCD) to detect vasospasm and predict changes in CBF will also be determined. These goals will be met by randomizing eligible patients with an acute aneurysmal SAH to receive normovolemic or hypervolemia therapy after surgical clipping of aneurysm. Serial measurements before and after institution of therapy will include 133Xenon CBF, Swan Ganz thermodilution cardiac output, blood pressure, pCO2, temperature, total blood volume, hematocrit, and velocities in proximal middle, anterior, and posterior cerebral arteries by TCD. Subjects in either treatment with hypertensive hypervolemia therapy and the above measurements continued.

描述：(调查人员摘要)在心脏破裂后 颅内动脉瘤，一个破坏性的并发症是发展成 血管痉挛引起的迟发性脑缺血。临床研究已经 表明预防性血管内容量扩张可能会减少 蛛网膜下腔出血后迟发性脑缺血的发生率 (SAH)，可能是通过改善脑血流(CBF)。然而， 治疗与脑血流量变化的关系还不够充分 下定决心。这项建议是一项临床生理学研究，比较了CBF 在术后2周内进行高容量血症和等容量治疗 动脉瘤性蛛网膜炎。两组的血液稀释将是相同的。其效果 以及心输出量、红细胞压积、血液 血压和脑血流量将被测定。次要的 将对CBF制度实施后的变化进行评估 高血压高容量治疗迟发性脑缺血 正常血容量和高血容量受试者。其敏感性和特异度 经颅多普勒(TCD)检测脑血管痉挛并预测脑血流变化 也将被确定。这些目标将通过随机化符合条件的 急性动脉瘤性蛛网膜下腔出血患者接受等容或 动脉瘤夹闭术后高容量血症的治疗。连载 治疗前后的测量将包括133Xenon CBF，Swan Ganz热稀释心输出量，血压，二氧化碳分压， 体温、总血容量、红细胞压积和近端血流速度 TCD显示大脑中动脉、大脑前动脉和大脑后动脉。中的主题 无论是采用高血压高容量疗法或以上疗法 测量仍在继续。