Intracranial Pressure After Subarachnoid Hemorrhage
OBJECTIVES:To describe mean intracranial pressure after aneurysmal subarachnoid hemorrhage, to identify clinical factors associated with increased mean intracranial pressure, and to explore the relationship between mean intracranial pressure and outcome. DESIGN:Analysis of a prospectively collected...
Gespeichert in:
| Veröffentlicht in: | Critical care medicine 2015-01, Vol.43 (1), p.168-176 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 176 |
|---|---|
| container_issue | 1 |
| container_start_page | 168 |
| container_title | Critical care medicine |
| container_volume | 43 |
| creator | Zoerle, Tommaso Lombardo, Alessandra Colombo, Angelo Longhi, Luca Zanier, Elisa R Rampini, Paolo Stocchetti, Nino |
| description | OBJECTIVES:To describe mean intracranial pressure after aneurysmal subarachnoid hemorrhage, to identify clinical factors associated with increased mean intracranial pressure, and to explore the relationship between mean intracranial pressure and outcome.
DESIGN:Analysis of a prospectively collected observational database.
SETTING:Neuroscience ICU of an academic hospital.
PATIENTS:One hundred sixteen patients with subarachnoid hemorrhage and intracranial pressure monitoring.
INTERVENTIONS:None.
MEASUREMENTS AND MAIN RESULTS:Episodes of intracranial pressure greater than 20 mm Hg lasting at least 5 minutes and the mean intracranial pressure for every 12-hour interval were analyzed. The highest mean intracranial pressure was analyzed in relation to demographic characteristics, acute neurologic status, initial radiological findings, aneurysm treatment, clinical vasospasm, and ischemic lesion. Mortality and 6-month outcome (evaluated using a dichotomized Glasgow Outcome Scale) were also introduced in multivariable logistic models. Eighty-one percent of patients had at least one episode of high intracranial pressure and 36% had a highest mean intracranial pressure more than 20 mm Hg. The number of patients with high intracranial pressure peaked 3 days after subarachnoid hemorrhage and declined after day 7. Highest mean intracranial pressure greater than 20 mm Hg was significantly associated with initial neurologic status, aneurysmal rebleeding, amount of blood on CT scan, and ischemic lesion within 72 hours from subarachnoid hemorrhage. Patients with highest mean intracranial pressure greater than 20 mm Hg had significantly higher mortality. When death, vegetative state, and severe disability at 6 months were pooled, however, intracranial pressure was not an independent predictor of unfavorable outcome.
CONCLUSIONS:High intracranial pressure is a common complication in the first week after subarachnoid hemorrhage in severe cases admitted to ICU. Mean intracranial pressure is associated with the severity of early brain injury and with mortality. |
| doi_str_mv | 10.1097/CCM.0000000000000670 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1637998041</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1637998041</sourcerecordid><originalsourceid>FETCH-LOGICAL-p1900-898d29196b99af07c63ba4f4db63623edcbaae7465e13e6ac7801973718701623</originalsourceid><addsrcrecordid>eNpdkEtLw0AUhQdRbK3-A5Es3aTeyU3msSxFbaGioK6HSXJjonnUmYTivzfSCuLZ3MX5uHA-xi45zDloebNcPszhb4SEIzblCUIIkcZjNgXQEGKsccLOvH8H4HEi8ZRNogS5QpVMGa7b3tnM2baydfDkyPvBUbAoenLB85DasSzbrsqDFTWdc6V9o3N2Utja08Xhztjr3e3LchVuHu_Xy8Um3HINECqt8khzLVKtbQEyE5jauIjzVKCIkPIstZZkLBLiSMJmUgHXEiVXEvhIzNj1_u_WdZ8D-d40lc-orm1L3eANFyi1VhDzEb06oEPaUG62rmqs-zK_Q0dA7YFdV4_T_Ec97MiZkmzdl4aD-XFqRqfmv1P8Bl-XZTU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1637998041</pqid></control><display><type>article</type><title>Intracranial Pressure After Subarachnoid Hemorrhage</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Zoerle, Tommaso ; Lombardo, Alessandra ; Colombo, Angelo ; Longhi, Luca ; Zanier, Elisa R ; Rampini, Paolo ; Stocchetti, Nino</creator><creatorcontrib>Zoerle, Tommaso ; Lombardo, Alessandra ; Colombo, Angelo ; Longhi, Luca ; Zanier, Elisa R ; Rampini, Paolo ; Stocchetti, Nino</creatorcontrib><description>OBJECTIVES:To describe mean intracranial pressure after aneurysmal subarachnoid hemorrhage, to identify clinical factors associated with increased mean intracranial pressure, and to explore the relationship between mean intracranial pressure and outcome.
DESIGN:Analysis of a prospectively collected observational database.
SETTING:Neuroscience ICU of an academic hospital.
PATIENTS:One hundred sixteen patients with subarachnoid hemorrhage and intracranial pressure monitoring.
INTERVENTIONS:None.
MEASUREMENTS AND MAIN RESULTS:Episodes of intracranial pressure greater than 20 mm Hg lasting at least 5 minutes and the mean intracranial pressure for every 12-hour interval were analyzed. The highest mean intracranial pressure was analyzed in relation to demographic characteristics, acute neurologic status, initial radiological findings, aneurysm treatment, clinical vasospasm, and ischemic lesion. Mortality and 6-month outcome (evaluated using a dichotomized Glasgow Outcome Scale) were also introduced in multivariable logistic models. Eighty-one percent of patients had at least one episode of high intracranial pressure and 36% had a highest mean intracranial pressure more than 20 mm Hg. The number of patients with high intracranial pressure peaked 3 days after subarachnoid hemorrhage and declined after day 7. Highest mean intracranial pressure greater than 20 mm Hg was significantly associated with initial neurologic status, aneurysmal rebleeding, amount of blood on CT scan, and ischemic lesion within 72 hours from subarachnoid hemorrhage. Patients with highest mean intracranial pressure greater than 20 mm Hg had significantly higher mortality. When death, vegetative state, and severe disability at 6 months were pooled, however, intracranial pressure was not an independent predictor of unfavorable outcome.
CONCLUSIONS:High intracranial pressure is a common complication in the first week after subarachnoid hemorrhage in severe cases admitted to ICU. Mean intracranial pressure is associated with the severity of early brain injury and with mortality.</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/CCM.0000000000000670</identifier><identifier>PMID: 25318385</identifier><language>eng</language><publisher>United States: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</publisher><subject>Brain - diagnostic imaging ; Brain - physiopathology ; Female ; Humans ; Intracranial Hypertension - etiology ; Intracranial Hypertension - physiopathology ; Intracranial Pressure - physiology ; Male ; Middle Aged ; Neuroimaging ; Prospective Studies ; Risk Factors ; Subarachnoid Hemorrhage - complications ; Subarachnoid Hemorrhage - diagnostic imaging ; Subarachnoid Hemorrhage - physiopathology ; Tomography, X-Ray Computed</subject><ispartof>Critical care medicine, 2015-01, Vol.43 (1), p.168-176</ispartof><rights>2015 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25318385$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zoerle, Tommaso</creatorcontrib><creatorcontrib>Lombardo, Alessandra</creatorcontrib><creatorcontrib>Colombo, Angelo</creatorcontrib><creatorcontrib>Longhi, Luca</creatorcontrib><creatorcontrib>Zanier, Elisa R</creatorcontrib><creatorcontrib>Rampini, Paolo</creatorcontrib><creatorcontrib>Stocchetti, Nino</creatorcontrib><title>Intracranial Pressure After Subarachnoid Hemorrhage</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVES:To describe mean intracranial pressure after aneurysmal subarachnoid hemorrhage, to identify clinical factors associated with increased mean intracranial pressure, and to explore the relationship between mean intracranial pressure and outcome.
DESIGN:Analysis of a prospectively collected observational database.
SETTING:Neuroscience ICU of an academic hospital.
PATIENTS:One hundred sixteen patients with subarachnoid hemorrhage and intracranial pressure monitoring.
INTERVENTIONS:None.
MEASUREMENTS AND MAIN RESULTS:Episodes of intracranial pressure greater than 20 mm Hg lasting at least 5 minutes and the mean intracranial pressure for every 12-hour interval were analyzed. The highest mean intracranial pressure was analyzed in relation to demographic characteristics, acute neurologic status, initial radiological findings, aneurysm treatment, clinical vasospasm, and ischemic lesion. Mortality and 6-month outcome (evaluated using a dichotomized Glasgow Outcome Scale) were also introduced in multivariable logistic models. Eighty-one percent of patients had at least one episode of high intracranial pressure and 36% had a highest mean intracranial pressure more than 20 mm Hg. The number of patients with high intracranial pressure peaked 3 days after subarachnoid hemorrhage and declined after day 7. Highest mean intracranial pressure greater than 20 mm Hg was significantly associated with initial neurologic status, aneurysmal rebleeding, amount of blood on CT scan, and ischemic lesion within 72 hours from subarachnoid hemorrhage. Patients with highest mean intracranial pressure greater than 20 mm Hg had significantly higher mortality. When death, vegetative state, and severe disability at 6 months were pooled, however, intracranial pressure was not an independent predictor of unfavorable outcome.
CONCLUSIONS:High intracranial pressure is a common complication in the first week after subarachnoid hemorrhage in severe cases admitted to ICU. Mean intracranial pressure is associated with the severity of early brain injury and with mortality.</description><subject>Brain - diagnostic imaging</subject><subject>Brain - physiopathology</subject><subject>Female</subject><subject>Humans</subject><subject>Intracranial Hypertension - etiology</subject><subject>Intracranial Hypertension - physiopathology</subject><subject>Intracranial Pressure - physiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neuroimaging</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Subarachnoid Hemorrhage - complications</subject><subject>Subarachnoid Hemorrhage - diagnostic imaging</subject><subject>Subarachnoid Hemorrhage - physiopathology</subject><subject>Tomography, X-Ray Computed</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtLw0AUhQdRbK3-A5Es3aTeyU3msSxFbaGioK6HSXJjonnUmYTivzfSCuLZ3MX5uHA-xi45zDloebNcPszhb4SEIzblCUIIkcZjNgXQEGKsccLOvH8H4HEi8ZRNogS5QpVMGa7b3tnM2baydfDkyPvBUbAoenLB85DasSzbrsqDFTWdc6V9o3N2Utja08Xhztjr3e3LchVuHu_Xy8Um3HINECqt8khzLVKtbQEyE5jauIjzVKCIkPIstZZkLBLiSMJmUgHXEiVXEvhIzNj1_u_WdZ8D-d40lc-orm1L3eANFyi1VhDzEb06oEPaUG62rmqs-zK_Q0dA7YFdV4_T_Ec97MiZkmzdl4aD-XFqRqfmv1P8Bl-XZTU</recordid><startdate>201501</startdate><enddate>201501</enddate><creator>Zoerle, Tommaso</creator><creator>Lombardo, Alessandra</creator><creator>Colombo, Angelo</creator><creator>Longhi, Luca</creator><creator>Zanier, Elisa R</creator><creator>Rampini, Paolo</creator><creator>Stocchetti, Nino</creator><general>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201501</creationdate><title>Intracranial Pressure After Subarachnoid Hemorrhage</title><author>Zoerle, Tommaso ; Lombardo, Alessandra ; Colombo, Angelo ; Longhi, Luca ; Zanier, Elisa R ; Rampini, Paolo ; Stocchetti, Nino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p1900-898d29196b99af07c63ba4f4db63623edcbaae7465e13e6ac7801973718701623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Brain - diagnostic imaging</topic><topic>Brain - physiopathology</topic><topic>Female</topic><topic>Humans</topic><topic>Intracranial Hypertension - etiology</topic><topic>Intracranial Hypertension - physiopathology</topic><topic>Intracranial Pressure - physiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neuroimaging</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Subarachnoid Hemorrhage - complications</topic><topic>Subarachnoid Hemorrhage - diagnostic imaging</topic><topic>Subarachnoid Hemorrhage - physiopathology</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zoerle, Tommaso</creatorcontrib><creatorcontrib>Lombardo, Alessandra</creatorcontrib><creatorcontrib>Colombo, Angelo</creatorcontrib><creatorcontrib>Longhi, Luca</creatorcontrib><creatorcontrib>Zanier, Elisa R</creatorcontrib><creatorcontrib>Rampini, Paolo</creatorcontrib><creatorcontrib>Stocchetti, Nino</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zoerle, Tommaso</au><au>Lombardo, Alessandra</au><au>Colombo, Angelo</au><au>Longhi, Luca</au><au>Zanier, Elisa R</au><au>Rampini, Paolo</au><au>Stocchetti, Nino</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intracranial Pressure After Subarachnoid Hemorrhage</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2015-01</date><risdate>2015</risdate><volume>43</volume><issue>1</issue><spage>168</spage><epage>176</epage><pages>168-176</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><abstract>OBJECTIVES:To describe mean intracranial pressure after aneurysmal subarachnoid hemorrhage, to identify clinical factors associated with increased mean intracranial pressure, and to explore the relationship between mean intracranial pressure and outcome.
DESIGN:Analysis of a prospectively collected observational database.
SETTING:Neuroscience ICU of an academic hospital.
PATIENTS:One hundred sixteen patients with subarachnoid hemorrhage and intracranial pressure monitoring.
INTERVENTIONS:None.
MEASUREMENTS AND MAIN RESULTS:Episodes of intracranial pressure greater than 20 mm Hg lasting at least 5 minutes and the mean intracranial pressure for every 12-hour interval were analyzed. The highest mean intracranial pressure was analyzed in relation to demographic characteristics, acute neurologic status, initial radiological findings, aneurysm treatment, clinical vasospasm, and ischemic lesion. Mortality and 6-month outcome (evaluated using a dichotomized Glasgow Outcome Scale) were also introduced in multivariable logistic models. Eighty-one percent of patients had at least one episode of high intracranial pressure and 36% had a highest mean intracranial pressure more than 20 mm Hg. The number of patients with high intracranial pressure peaked 3 days after subarachnoid hemorrhage and declined after day 7. Highest mean intracranial pressure greater than 20 mm Hg was significantly associated with initial neurologic status, aneurysmal rebleeding, amount of blood on CT scan, and ischemic lesion within 72 hours from subarachnoid hemorrhage. Patients with highest mean intracranial pressure greater than 20 mm Hg had significantly higher mortality. When death, vegetative state, and severe disability at 6 months were pooled, however, intracranial pressure was not an independent predictor of unfavorable outcome.
CONCLUSIONS:High intracranial pressure is a common complication in the first week after subarachnoid hemorrhage in severe cases admitted to ICU. Mean intracranial pressure is associated with the severity of early brain injury and with mortality.</abstract><cop>United States</cop><pub>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</pub><pmid>25318385</pmid><doi>10.1097/CCM.0000000000000670</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0090-3493 |
| ispartof | Critical care medicine, 2015-01, Vol.43 (1), p.168-176 |
| issn | 0090-3493 1530-0293 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1637998041 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Brain - diagnostic imaging Brain - physiopathology Female Humans Intracranial Hypertension - etiology Intracranial Hypertension - physiopathology Intracranial Pressure - physiology Male Middle Aged Neuroimaging Prospective Studies Risk Factors Subarachnoid Hemorrhage - complications Subarachnoid Hemorrhage - diagnostic imaging Subarachnoid Hemorrhage - physiopathology Tomography, X-Ray Computed |
| title | Intracranial Pressure After Subarachnoid Hemorrhage |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T16%3A20%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Intracranial%20Pressure%20After%20Subarachnoid%20Hemorrhage&rft.jtitle=Critical%20care%20medicine&rft.au=Zoerle,%20Tommaso&rft.date=2015-01&rft.volume=43&rft.issue=1&rft.spage=168&rft.epage=176&rft.pages=168-176&rft.issn=0090-3493&rft.eissn=1530-0293&rft_id=info:doi/10.1097/CCM.0000000000000670&rft_dat=%3Cproquest_pubme%3E1637998041%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1637998041&rft_id=info:pmid/25318385&rfr_iscdi=true |