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Observational Study
Monitoring of the Effect of Cerebral Autoregulation on Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage.
- Guojing Liu, Zongduo Guo, Xiaochuan Sun, WeiNa Chai, Lingjun Qi, Hui Li, Jianfeng Zheng, Tengyun Guo, Zhaohui He, Xiaodong Zhang, Ji Zhu, and Yetao Luo.
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, China.
- World Neurosurg. 2018 Oct 1; 118: e269-e275.
ObjectiveTo detect cerebral autoregulation (CA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) by near-infrared spectroscopy and to assess its association with delayed cerebral ischemia (DCI).MethodsFrom January to August 2017, 81 patients (average age 53.25 ± 10.27 years) were studied. Near-infrared spectroscopy was used to monitor CA, and associated factors were evaluated. Monitoring of CA was carried out at 5 time points (preoperative day 1 and postoperative days 1, 2, 3, and 7). Patients were sorted into 2 groups according to whether DCI occurred (DCI group and non-DCI group). The relationship between CA and DCI in patients with aSAH was analyzed.ResultsAmong 81 patients, CA trended toward being impaired in patients with aSAH with a poorer grade. DCI occurred in 39 of 51 (48.15%) patients with impaired CA. DCI occurred in 6 of 30 (7.4%) patients with intact CA.ConclusionsImpaired CA monitored by near-infrared spectroscopy was shown in patients with aSAH before and after surgical intervention. Older age, smoking, hypertension, and especially impaired CA are independent risk factors for patients with DCI.Copyright © 2018 Elsevier Inc. All rights reserved.
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