2009 Fiscal Year Final Research Report
Analysis of cardiopulmonary function after subarachnoid hemorrhage
| Project/Area Number |
20592117
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Emergency medicine
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| Research Institution | Tokyo Medical and Dental University |
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Principal Investigator |
ISOTANI Eiji Tokyo Medical and Dental University, 医学部附属病院, 講師 (90251529)
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| Project Period (FY) |
2008 – 2009
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| Keywords | subarachnoid hemorrhage / pulmonary edema / triple H therapy / cerebral vasospasm / extravasucular lung water index |
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| Research Abstract |
Objectives : Volume management is crucial in intensive care, however, in some patients it is very hard to achieve optimal water balance. Subarachnoid hemorrhage (SAH) patient is a representative example. Cardiopulmonary complications are common after SAH : neurogenic pulmonary edema, cardiac failure, and so on. We have started the multicenter controlled trial about cardiopulmonary function after SAH. In this study we will present the effects of PiCCO plus monitoring after SAH. Methods : We analyzed the cardiopulmonary functions of 62 patients monitored by PiCCO plus during two weeks after SAH. Results : Output, contractility and afterload were essentially normal after SAH. Intrathoracic blood volume was slightly elevated and this fluid redistribution causes hydrostatic fluid retention in lung tissues on PiCCO monitoring after SAH. Conclusions : Persistent catecholamine release and the different sensitivity of blood vessels to catecholamine cause the blood volume redistribution and hydrostatic pulmonary edema. The cardiac preload due to catecholamine release leads to BNP release resulted in natriuresis. This is the underlying mechanism of so-called cerebral salt wasting syndrome.
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Research Products
(18 results)
