Pulmonary function and radiographic abnormalities related to neurological outcome after aneurysmal subarachnoid hemorrhage

Journal of Neurosurgery
A GruberB Richling

Abstract

This observational study is based on a consecutive series of 207 patients with aneurysmal subarachnoid hemorrhage who were treated within 7 days of their most recent bleed. The purpose of the study was to evaluate the effect of respiratory failure on neurological outcome. Pulmonary function was assessed by determination of parameters describing pulmonary oxygen transport and exchange, by using composite scores for quantification of lung injury (lung injury score [LIS]) and mechanical ventilator settings (PIF score). Pulmonary function was related to the Hunt and Hess (H & H) grade assigned to the patient at hospital admission (p < 0.001). The pattern and time course of lung injury differed significantly between patients with H & H Grade I or II, Grade III, and Grade IV or V. Hunt and Hess grade, Fisher computerized tomography grade, intracranial pressure, cerebral perfusion pressure, LIS, ratio of PaO2 to the fraction of inspired oxygen (FiO2), and the ratio of the alveolar-minus-arterial oxygen tension difference (AaDO2) to FiO2 were related to neurological outcome (p < 0.001). The LIS on the day of maximum lung injury remained an independent predictor of outcome (p = 0.01) in a stepwise logistic regression analysis. The proba...Continue Reading

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Citations

Sep 20, 2007·Der Anaesthesist·A S SarrafzadehW Boemke
Mar 28, 2007·Intensive Care Medicine·Yoshiaki TeraoKoji Sumikawa
May 2, 2009·Neurocritical Care·Andrew M NaidechThomas P Bleck
Sep 15, 2010·Neurocritical Care·Rachel MeyerMiriam M Treggiari
May 12, 2005·Annales Françaises D'anesthèsie Et De Rèanimation·P HansH Dufour
Jun 3, 2008·Neurologic Clinics·Robert D StevensJulio A Chalela
May 8, 2015·Pediatric Research·Luis ArruzaJose Martínez-Orgado
Aug 12, 2014·BioMed Research International·Sheng ChenJohn H Zhang
Apr 18, 2003·Neurosurgery·Jonathan A FriedmanEelco F M Wijdicks
Mar 24, 2007·Acta Anaesthesiologica Scandinavica·A BaumannP M Mertes
Dec 24, 2005·Critical Care Medicine·Jeremy M KahnGordon D Rubenfeld
Aug 13, 2002·Journal of Neurosurgical Anesthesiology·Bernhard WalderDenis R Morel
Sep 26, 2020·Critical Care : the Official Journal of the Critical Care Forum·James E TownerDebra E Roberts

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