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The relationship between the time of cerebral desaturation episodes and outcome in aneurysmal subarachnoid haemorrhage: a preliminary study.

Published version
Peer-reviewed

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Authors

Burzyńska, Małgorzata 
Kasprowicz, Magdalena 
Czosnyka, Marek 
Dragan, Barbara 

Abstract

In this preliminary study we investigated the relationship between the time of cerebral desaturation episodes (CDEs), the severity of the haemorrhage, and the short-term outcome in patients with aneurysmal subarachnoid haemorrhage (aSAH). Thirty eight patents diagnosed with aneurysmal subarachnoid haemorrhage were analysed in this study. Regional cerebral oxygenation (rSO2) was assessed using near infrared spectroscopy (NIRS). A CDE was defined as rSO2 < 60% with a duration of at least 30 min. The severity of the aSAH was assessed using the Hunt and Hess scale and the short-term outcome was evaluated utilizing the Glasgow Outcome Scale. CDEs were found in 44% of the group. The total time of the CDEs and the time of the longest CDE on the contralateral side were longer in patients with severe versus moderate aSAH [h:min]: 8:15 (6:26-8:55) versus 1:24 (1:18-4:18), p = 0.038 and 2:05 (2:00-5:19) versus 0:48 (0:44-2:12), p = 0.038. The time of the longest CDE on the ipsilateral side was longer in patients with poor versus good short-term outcome [h:min]: 5:43 (3:05-9:36) versus 1:47 (0:42-2:10), p = 0.018. The logistic regression model for poor short-term outcome included median ABP, the extent of the haemorrhage in the Fisher scale and the time of the longest CDE. We have demonstrated that the time of a CDE is associated with the severity of haemorrhage and short-term outcome in aSAH patients. A NIRS measurement may provide valuable predictive information and could be considered as additional method of neuromonitoring of patients with aSAH.

Description

Keywords

Critical care, Glasgow outcome scale, Hypoxia, Near-infrared spectroscopy, Subarachnoid haemorrhage, Adult, Aged, Aneurysm, Brain, Female, Glasgow Outcome Scale, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Monitoring, Intraoperative, Oxygen, Regression Analysis, Retrospective Studies, Spectroscopy, Near-Infrared, Subarachnoid Hemorrhage, Time Factors, Tomography, X-Ray Computed, Treatment Outcome

Journal Title

J Clin Monit Comput

Conference Name

Journal ISSN

1387-1307
1573-2614

Volume Title

34

Publisher

Springer Science and Business Media LLC
Sponsorship
Narodowe Centrum Nauki (2013/09/B/NZ4/01343)
WUT statutory funds (0401/0040/18)