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Effects of Induced Hypertension on Cerebral Perfusion in Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial.
Gathier, Celine S; Dankbaar, Jan Willem; van der Jagt, Mathieu; Verweij, Bon H; Oldenbeuving, Annemarie W; Rinkel, Gabriel J E; van den Bergh, Walter M; Slooter, Arjen J C.
  • Gathier CS; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
  • Dankbaar JW; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
  • van der Jagt M; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
  • Verweij BH; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
  • Oldenbeuving AW; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
  • Rinkel GJ; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
  • van den Bergh WM; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
  • Slooter AJ; From the Departments of Intensive Care Medicine (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care, Erasmu
Stroke ; 46(11): 3277-81, 2015 Nov.
Article en En | MEDLINE | ID: mdl-26443829
ABSTRACT
BACKGROUND AND

PURPOSE:

The presumed effectiveness of induced hypertension for treating delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage is based on uncontrolled case-series only. We assessed the effect of induced hypertension on cerebral blood flow (CBF) in aneurysmal subarachnoid hemorrhage patients with delayed cerebral ischemia in a randomized clinical trial.

METHODS:

Aneurysmal subarachnoid hemorrhage patients were randomized to induced or no induced hypertension (control group) at delayed cerebral ischemia onset. CBF was assessed, blinded for treatment allocation, with computed tomographic perfusion in standardized predefined regions at delayed cerebral ischemia onset and after 24 to 36 hours of study treatment. Mean arterial blood pressure was compared between groups (linear mixed model). The primary outcome measure was the difference in change in overall CBF (Mann-Whitney U test).

RESULTS:

Mean arterial blood pressure was, on average, 12 mm Hg (95% confidence interval, 8.6-14.5) higher in the hypertension group (n=12) than in the control group (n=13). Change in overall CBF (mL/100g per s) was -8.5 (range, -42 to 30) in the control group and 0.1 (range, -31-43) in the hypertension group (P=0.25).

CONCLUSIONS:

Change in overall CBF did not differ to a statistically significant extent between the groups. Based on our results, 225 to 250 patients per group are needed to find a statistically significant difference in change in overall CBF between induced hypertension and no hypertension. CLINICAL TRIAL REGISTRATION URL http//www.clinicaltrials.gov. Unique identifier NCT0161323.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Vasoconstrictores / Norepinefrina / Isquemia Encefálica / Hipertensión Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2015 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Search on Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Vasoconstrictores / Norepinefrina / Isquemia Encefálica / Hipertensión Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2015 Tipo del documento: Article