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Global End-Diastolic Volume is Associated with the Occurrence of Delayed Cerebral Ischemia and Pulmonary Edema After Subarachnoid Hemorrhage.
MedLine Citation:
PMID:  22832713     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT: Predictive variables of delayed cerebral ischemia (DCI) and pulmonary edema following subarachnoid hemorrhage (SAH) remain unknown. We aimed to determine associations between transpulmonary thermodilution-derived variables and DCI and pulmonary edmea occurrence after SAH. We reviewed 34 consecutive SAH patients monitored by the PiCCO® system. Six patients developed DCI at 7 days after SAH on average; 28 did not (non-DCI). We compared the variable measures for 1 day before DCI occurred (DCI day -1) in the DCI group and 6 days after SAH (non-DCI day -1) in the non-DCI group for control. The mean value of the global end-diastolic volume index (GEDI) for DCI day -1 was lower than that for non-DCI day -1 (676 ± 65 mL/m vs. 872 ± 85 mL/m, p = 0.04). Central venous pressure (CVP) was not significantly different (7.8 ± 3.1 cm H2O vs. 9.4 ± 1.9 cm H2O, p = 0.45). At day -1 for both DCI and non-DCI, 11 patients (32%) had pulmonary edema. GEDI was significantly higher in patients with pulmonary edema than in those without this condition (947 ± 126 mL/m vs. 766 ± 81 mL/m, p = 0.02); CVP was not significantly different (8.7 ± 2.8 cm H2O vs. 9.2 ± 2.1 cm H2O, p = 0.78). Although significant correlation was found between extravascular lung water (EVLW) measures and GEDI (r = 0.58, p = 0.001), EVLW and CVP were not correlated (r = 0.03, p = 0.88). Thus, GEDI might be associated with DCI occurrence and EVLW accumulation after SAH.
Authors:
Akihiro Watanabe; Takashi Tagami; Shoji Yokobori; Gaku Matsumoto; Yutaka Igarashi; Go Suzuki; Hidetaka Onda; Akira Fuse; Hiroyuki Yokota
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-24
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
* Departments of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan †Department of Neurosurgery, University of Miami, Miller School of Medicine, Lois Pope LIFE Center, 3-25 ee 1095 NW 14th terrace, Miami, FL 33136, USA.
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