| Title |
Controlled Hypercapnia Enhances Cerebral Blood Flow and Brain Tissue Oxygenation After Aneurysmal Subarachnoid Hemorrhage: Results of a Phase 1 Study
|
|---|---|
| Published in |
Neurocritical Care, February 2016
|
| DOI | 10.1007/s12028-016-0246-x |
| Pubmed ID | |
| Authors |
Thomas Westermaier, Christian Stetter, Ekkehard Kunze, Nadine Willner, Judith Holzmeier, Judith Weiland, Stefan Koehler, Christopher Lotz, Christian Kilgenstein, Ralf-Ingo Ernestus, Norbert Roewer, Ralf Michael Muellenbach |
| Abstract |
This study investigated if cerebral blood flow (CBF) regulation by changes of the arterial partial pressure of carbon dioxide (PaCO2) can be used therapeutically to increase CBF and improve neurological outcome after subarachnoid hemorrhage (SAH). In 12 mechanically ventilated poor-grade SAH-patients, a daily trial intervention was performed between day 4 and 14. During this intervention, PaCO2 was decreased to 30 mmHg and then gradually increased to 40, 50, and 60 mmHg in 15-min intervals by modifications of the respiratory minute volume. CBF and brain tissue oxygen saturation (StiO2) were the primary and secondary endpoints. Intracranial pressure was controlled by an external ventricular drainage. CBF reproducibly decreased during hyperventilation and increased to a maximum of 141 ± 53 % of baseline during hypercapnia (PaCO2 60 mmHg) on all days between day 4 and 14 after SAH. Similarly, StiO2 increased during hypercapnia. CBF remained elevated within the first hour after resetting ventilation to baseline parameters and no rebound effect was observed within this time-span. PaCO2-reactivities of CBF and StiO2 were highest between 30 and 50 mmHg and slightly decreased at higher levels. CBF and StiO2 reproducibly increased by controlled hypercapnia of up to 60 mmHg even during the period of the maximum expected vasospasm. The absence of a rebound effect within the first hour after hypercapnia indicates that an improvement of the protocol is possible. The intervention may yield a therapeutic potential to prevent ischemic deficits after aneurysmal SAH. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 50% |
| Spain | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 55 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 2% |
| Unknown | 54 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 10 | 18% |
| Other | 5 | 9% |
| Student > Bachelor | 5 | 9% |
| Student > Postgraduate | 5 | 9% |
| Researcher | 4 | 7% |
| Other | 12 | 22% |
| Unknown | 14 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 38% |
| Engineering | 5 | 9% |
| Neuroscience | 4 | 7% |
| Nursing and Health Professions | 2 | 4% |
| Economics, Econometrics and Finance | 2 | 4% |
| Other | 4 | 7% |
| Unknown | 17 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 February 2016.
All research outputs
#18,441,836
of 22,849,304 outputs
Outputs from Neurocritical Care
#1,271
of 1,494 outputs
Outputs of similar age
#216,421
of 297,955 outputs
Outputs of similar age from Neurocritical Care
#18
of 25 outputs
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