| Which H is the most important in triple-H therapy for cerebral vasospasm? | |
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MedLine Citation:
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PMID: 19276798 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: To summarize the recent literature of the hemodynamic management of subarachnoid hemorrhage and cerebral vasospasm, also designated as 'triple-H' therapy, and discuss each component of this management approach individually. RECENT FINDINGS: Following the publication of a review on circulatory volume expansion in the Cochrane Registry database in 2004 and a meta-analysis in 2003, there are no new randomized trials of triple-H therapy to prevent or treat cerebral vasospasm. However, physiological studies have been reported that contribute to the understanding of some of the components of triple-H therapy. SUMMARY: There remains a paucity of information regarding the efficacy and safety of triple-H therapy. The complexity in exploring this topic derives not only from the interdependence of the different components of triple-H therapy but also by the limitation in the assessment of hemodynamic variables. However, there is some emerging physiologic data suggesting that normovolemic hypertension may be the component most likely to increase cerebral blood flow after subarachnoid hemorrhage. In contrast, hypervolemic hemodilution is associated with increased complications and might also lower the hemoglobin to excessively low levels. |
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Authors:
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Miriam M Treggiari; Steven Deem |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in critical care Volume: 15 ISSN: 1531-7072 ISO Abbreviation: Curr Opin Crit Care Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-20 Completed Date: 2009-10-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9504454 Medline TA: Curr Opin Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 83-6 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, Washington 98104, USA. treggmm@u.washington.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Circulation Blood Volume* Cerebrovascular Circulation / physiology Hemodilution* Hemodynamics Humans Hypertension* Subarachnoid Hemorrhage / physiopathology, therapy Vasospasm, Intracranial / physiopathology, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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