Pulmonary and circulatory parameter guided anesthesia in patients with ischemic stroke undergoing endovascular recanalization

Journal of Neurointerventional Surgery
Sibu MundiyanapurathJ Bösel

Abstract

Endovascular recanalization in ischemic stroke is often performed under general anesthesia. Some studies have shown a detrimental effect of general anesthesia. The reasons are unknown. This was an observational study with retrospective and prospective phases. From 2008 to 2010, 60 patients treated by endovascular recanalization due to proximal vessel occlusion were analyzed with regard to ventilation parameters, blood gas values, blood pressure, and clinical parameters (pre-protocol phase). Subsequently, a protocol with target values for end-tidal CO2 (Petco2) and systolic blood pressure (SBP) was introduced and prospectively analyzed in 64 patients in 2012 (protocol phase). In the pre-protocol phase, significant hypocapnia (<30 mm Hg), a decrease in SBP after intervention (p<0.001), and an increase in SBP after extubation (p<0.001) were observed. After implementing the protocol in 2012, 63% of Petco2 values and 55% of SBP values (median) of the duration of intervention were within the predefined range. Severe hypocapnia and hypotension (SBP <100 mm Hg) after the intervention were significantly reduced. Longer duration of Petco2 values within 40-45 mm Hg, intracerebral hemorrhage, longer door to needle time, older age, unsucces...Continue Reading

References

Sep 1, 1987·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·J A BevanR D Bevan
Jan 1, 1982·Stroke; a Journal of Cerebral Circulation·S C Stein, R Q Cracco
Nov 22, 1997·Stroke; a Journal of Cerebral Circulation·G RordorfW J Koroshetz
May 4, 2002·Stroke; a Journal of Cerebral Circulation·Jo Leonardi-BeeUNKNOWN IST Collaborative Group
Jul 5, 2002·The New England Journal of Medicine·John G Laffey, Brian P Kavanagh
Jan 8, 2009·Neurocritical Care·Marek CzosnykaLuzius A Steiner
Jun 11, 2009·Brain : a Journal of Neurology·Ferdinand MiteffMark W Parsons
Sep 15, 2009·Lancet Neurology·Valérie TikhonoffJan A Staessen
Oct 12, 2010·Stroke; a Journal of Cerebral Circulation·Rishi Gupta
Oct 12, 2010·Stroke; a Journal of Cerebral Circulation·Carlos A Molina, Magdy H Selim
Oct 12, 2010·Stroke; a Journal of Cerebral Circulation·Caspar BrekenfeldGerhard Schroth
Mar 12, 2011·AJNR. American Journal of Neuroradiology·R P H BokkersJ Hendrikse
Jan 10, 2012·Anesthesiology·Melinda J DavisUNKNOWN Calgary Stroke Program
Jan 25, 2012·Neurocritical Care·Oliver HerrmannRoland Veltkamp
Oct 4, 2012·Neurology·Michael T FroehlerDavid L McDonagh
Jun 14, 2013·Journal of Neurointerventional Surgery·Matthew K WhalinRishi Gupta
Mar 29, 2014·Stroke; a Journal of Cerebral Circulation·Alex Abou-CheblRaul G Nogueira
Jul 22, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Alexander C FlintUNKNOWN SITS International and VISTA-plus investigators

❮ Previous
Next ❯

Citations

Mar 26, 2016·Clinical Case Reports·Hannah FuhrerWolf-Dirk Niesen
Oct 21, 2015·World Neurosurgery·Adam S Arthur, Adam S Arthur
Nov 29, 2015·Journal of Neurointerventional Surgery·Chitra SivasankarW Andrew Kofke
Feb 6, 2017·Current Opinion in Critical Care·Julian Bösel
Aug 2, 2017·Journal of Neurosurgical Anesthesiology·Umeshkumar AthiramanDeepak Sharma
May 20, 2017·Stroke; a Journal of Cerebral Circulation·Pia Löwhagen HendénSven-Erik Ricksten
Aug 28, 2015·Der Nervenarzt·S Schönenberger, J Bösel
Aug 30, 2019·Stroke; a Journal of Cerebral Circulation·Benjamin MaïerMikael Mazighi
Jan 14, 2020·Hypertension·Konark MalhotraGeorgios Tsivgoulis
Jul 9, 2017·Neurology·Katja E Wartenberg, Stephan A Mayer
Jul 21, 2017·Current Opinion in Anaesthesiology·Arthur Wang, Apolonia E Abramowicz
Feb 20, 2020·Journal of Neurointerventional Surgery·Stephen ProbstDavid Fiorella
Sep 22, 2015·Current Treatment Options in Neurology·Julian Bösel
Aug 30, 2019·Medizinische Klinik, Intensivmedizin und Notfallmedizin·S Schönenberger, J Bösel
Jul 28, 2019·Intensive Care Medicine·M SmithG Citerio
Feb 19, 2021·Journal of Stroke·Katharina FeilUNKNOWN GSR Investigators
Oct 12, 2020·Anaesthesia Critical Care & Pain Medicine·Arnaud ValentEtienne Gayat

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Related Papers

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Sibu MundiyanapurathJ Bösel
International Journal of Stroke : Official Journal of the International Stroke Society
Silvia SchönenbergerJ Bösel
© 2021 Meta ULC. All rights reserved