Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage

To identify a minimally acceptable cerebral perfusion pressure threshold above which the risks of brain tissue hypoxia (BTH) and oxidative metabolic crisis are reduced for patients with subarachnoid hemorrhage (SAH). We studied 30 poor-grade SAH patients who underwent brain multimodality monitoring...

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Bibliographic Details
Published in:Stroke (1970) 2011-05, Vol.42 (5), p.1351-1356
Main Authors: SCHMIDT, J. Michael, KO, Sang-Bae, CLAASSEN, Jan, MAYER, Stephan A, HELBOK, Raimund, KURTZ, Pedro, MORGAN STUART, R, PRESCIUTTI, Mary, FERNANDEZ, Luis, LEE, Kiwon, BADJATIA, Neeraj, SANDER CONNOLLY, E
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Energy Metabolism - physiology
Female
Glucose - metabolism
Humans
Hypoxia, Brain - epidemiology
Hypoxia, Brain - physiopathology
Lactates - metabolism
Logistic Models
Male
Medical sciences
Middle Aged
Multivariate Analysis
Neurology
Oxidative Stress - physiology
Perfusion
Pharmacology. Drug treatments
Pyruvates - metabolism
Retrospective Studies
Risk Factors
Subarachnoid Hemorrhage - metabolism
Subarachnoid Hemorrhage - physiopathology
Vascular diseases and vascular malformations of the nervous system
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Summary:To identify a minimally acceptable cerebral perfusion pressure threshold above which the risks of brain tissue hypoxia (BTH) and oxidative metabolic crisis are reduced for patients with subarachnoid hemorrhage (SAH). We studied 30 poor-grade SAH patients who underwent brain multimodality monitoring (3042 hours). Physiological measures were averaged over 60 minutes for each collected microdialysis sample. Metabolic crisis was defined as a lactate/pyruvate ratio>40 with a brain glucose concentration≤0.7 mmol/L. BTH was defined as PbtO2
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.110.596874