tailieunhanh - Báo cáo y học: " Hypertension may be the most important component of hyperdynamic therapy in cerebral vasospasm"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Hypertension may be the most important component of hyperdynamic therapy in cerebral vasospasm. | Harrigan Critical Care 2010 14 151 http content 14 3 151 CRITICAL CARE COMMENTARY L__ Hypertension may be the most important component of hyperdynamic therapy in cerebral vasospasm Mark R Harrigan See related research by Dankbaar etal. http content 14 1 R23 Abstract Although hyperdynamic therapy is an accepted method of treatment of patients with symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage it remains unproven in large scale trials and controlled studies. Furthermore methods of hyperdynamic therapy and specific endpoints vary widely. A systematic review of clinical trials of the various techniques of hyperdynamic therapy and their effects on cerebral blood flow found only 11 studies suitable for analysis. Although controlled trials are lacking there is some evidence to suggest that hypertension is the most promising component of hyperdynamic therapy. These findings support a future randomized trial of induced hypertension in patients with symptomatic cerebral vasospasm. In a previous issue of Critical Care Dankbaar and colleagues 1 presented a systematic review of clinical studies of hyperdynamic therapy and its components on cerebral blood flow CBF . Symptomatic cerebral vasospasm is defined as cerebral ischemia attributable to narrowing of intracranial arteries and loss of cerebral autoregulation and afflicts some 20 to 25 of patients after rupture of an intracranial aneurysm 2 3 . The cornerstone of medical therapy for cerebral vasospasm is so-called hyperdynamic therapy. Also referred to as triple-H therapy this strategy includes the use of hypertension hypervolemia and hemodilution to optimize cerebral perfusion. Introduced in the 1970s this management strategy has become widely accepted as first-line treatment for symptomatic vasospasm and is probably Correspondence mharrigan@ Department of Surgery Division of Neurosurgery University of Alabama at Birmingham 510 20th Street South Birmingham

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