Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm.

Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm. Research Abstract Details 

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Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm. Abstract Text:

Michael N Diringer,Yekaterina Axelrod,

PURPOSE OF REVIEW: The intent of this manuscript is to summarize the pathophysiologic basis for hemodynamic manipulation in subarachnoid hemorrhage and traumatic brain injury, highlight the most recent literature and present expert opinion on indications and use. RECENT FINDINGS: Hemodynamic augmentation with vasopressors and inotropes along with hypervolemia are the mainstay of treatment of vasospasm due to subarachnoid hemorrhage. Considerable variation continues to exist regarding fluid management and the use of vasopressors and inotropes. Blood pressure augmentation, volume expansion and cardiac contractility enhancement improve cerebral blood flow in ischemic areas, ameliorate vasospasm and improve clinical condition. In patients suffering from severe traumatic brain injury, while every attempt is made to control intracranial hypertension, cerebral perfusion-directed therapy with fluids and vasopressors is also used to keep cerebral perfusion pressure above 60-70 mmHg. Yet, recent observations suggest that posttraumatic mitochondrial dysfunction has been proposed as an alternative explanation for lower cerebral blood flow after acute trauma. SUMMARY: Hemodynamic manipulation is routinely used in the management of patients with acute vasospasm following subarachnoid hemorrhage and severe head injury. The rationale is to improve blood flow to the injured brain and prevent secondary ischemia.

Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm. Publishing Authors By Initials

MN Diringer,Y Axelrod,

For similar nervous system diseases: central nervous system diseases: brain diseases: cerebrovascular disorders: vasospasm, intracranial research abstracts see: nervous system diseases: central nervous system diseases: brain diseases: cerebrovascular disorders: vasospasm, intracranial research

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Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm. Journal Published:

PUBLICATION TYPE: Review

Journal: Current opinion in critical care

VOLUME: 13

Page Numbers: 156-62

Journal Abbreviation:

ISSN: 1070-5295

DAY: 3

MONTH: Apr

YEAR: 2007

Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm. Information

Number of References: 101

LANGUAGE: eng

NlmUniqueID: 9504454

Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm. Keywords Mesh Terms:

KEYWORDS: Vasospasm, Intracranial

MESH TERMS: therapy

Chemical & Substance for Abstract: Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm. Information

Substance Name: Vasoconstrictor Agents

Registry Number: 0

Grant and Affiliation Information for Hemodynamic manipulation in the neuro-intensive care unit: cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm.

AFFILIATION: Neurology/Neurosurgery Intensive Care Unit, Barnes-Jewish Hospital, Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA. diringerm@neuro.wustl.edu

Country: United States

AGENCY: United States PHS

GRANT: N535966

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MEDLINETA: Curr Opin Crit Care

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