• Mohit Mittal, M Radhakrishnan, and G S UmamaheswaraRao.
• Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bangalore, India.
• J Clin Anesth. 2015 Sep 1; 27 (6): 527-30.

AbstractHypertensive, hypervolumic, and hemodilution therapy (triple-H therapy) is administered to patients with symptomatic cerebral vasospasm after intracranial aneurysm clipping. This therapy can sometimes result in cardiac dysfunction because of pharmacologically induced hyperadrenergic state. The diagnosis may be missed if blood pressure alone is monitored to guide triple-H therapy. In this report, we describe one such patient who developed cardiac failure after triple-H therapy. This was diagnosed by using a bioreactance noninvasive cardiac output monitoring. Continuous cardiac output monitoring by this technique facilitated treatment of cardiac failure with milrinone and dobutamine. At discharge, the patient had no neurologic deficits.Copyright © 2015 Elsevier Inc. All rights reserved.

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