Protocolized Brain Oxygen Optimization in Subarachnoid Hemorrhage
Background Brain tissue hypoxia (P bt O 2
Gespeichert in:
| Veröffentlicht in: | Neurocritical care 2019-10, Vol.31 (2), p.263-272 |
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| creator | Rass, Verena Solari, Daria Ianosi, Bogdan Gaasch, Max Kofler, Mario Schiefecker, Alois J. Miroz, John-Paul Morelli, Paola Thomé, Claudius Beer, Ronny Pfausler, Bettina Oddo, Mauro Helbok, Raimund |
| description | Background
Brain tissue hypoxia (P
bt
O
2
|
| doi_str_mv | 10.1007/s12028-019-00753-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6757026</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2244140396</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-f47b839dcc401c768605391a9f2d76e062e87ac8a2e30dc448d7f484342abbd33</originalsourceid><addsrcrecordid>eNp9kUtLxDAQx4Movr-AB1nw4qU6eTRpLoIuvkBQUM8hTdPdSNusSSvqpzfr-j54mpnMb_6T4Y_QDoYDDCAOIyZAigywzFKZ0wyW0DrOc56B5Hh5njOccUnpGtqI8QGACCnyVbRGMcEFZ7COjm-C773xjXu11egkaNeNrp9fJjaFWe9a96p757tRer4dSh20mXbeVaML2_oQpnpit9BKrZtotz_iJro_O70bX2RX1-eX4-OrzDDB-qxmoiyorIxhgI3gBYecSqxlTSrBLXBiC6FNoYmlUBnGikrUrGCUEV2WFaWb6GihOxvK1lbGdn3QjZoF1-rworx26nenc1M18U-Ki1wA4Ulg_0Mg-MfBxl61LhrbNLqzfoiKEMYwAyrn6N4f9MEPoUvnKSKxzBnLMU4UWVAm-BiDrb8-g0HNHVILh1RySL07pCAN7f4842vk05IE0AUQU6ub2PC9-x_ZN8HTnAM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919544511</pqid></control><display><type>article</type><title>Protocolized Brain Oxygen Optimization in Subarachnoid Hemorrhage</title><source>MEDLINE</source><source>ProQuest Central (Alumni Edition)</source><source>Springer Nature - Complete Springer Journals</source><source>ProQuest Central UK/Ireland</source><source>ProQuest Central</source><creator>Rass, Verena ; Solari, Daria ; Ianosi, Bogdan ; Gaasch, Max ; Kofler, Mario ; Schiefecker, Alois J. ; Miroz, John-Paul ; Morelli, Paola ; Thomé, Claudius ; Beer, Ronny ; Pfausler, Bettina ; Oddo, Mauro ; Helbok, Raimund</creator><creatorcontrib>Rass, Verena ; Solari, Daria ; Ianosi, Bogdan ; Gaasch, Max ; Kofler, Mario ; Schiefecker, Alois J. ; Miroz, John-Paul ; Morelli, Paola ; Thomé, Claudius ; Beer, Ronny ; Pfausler, Bettina ; Oddo, Mauro ; Helbok, Raimund</creatorcontrib><description><![CDATA[Background
Brain tissue hypoxia (P
bt
O
2
< 20 mmHg) is common after subarachnoid hemorrhage (SAH) and associated with poor outcome. Recent data suggest that brain oxygen optimization is feasible and reduces the time spent with P
bt
O
2
< 20 mmHg from 45 to 16% in patients with severe traumatic brain injury. Here, we intended to quantify the brain tissue hypoxia burden despite implementation of a protocolized treatment approach in poor-grade SAH patients and to identify the simultaneous occurrence of pathologic values potentially amenable to treatment.
Methods
We present a bi-centric observational cohort study including 100 poor-grade SAH patients admitted to two tertiary care centers who underwent multimodal brain monitoring and were managed with a P
bt
O
2
-targeted protocolized approach. P
bt
O
2
optimization (≥ 20 mmHg) included a stepwise neuro-intensive care approach, aiming to prevent low cerebral perfusion pressure (CPP), and blood hemoglobin, and to keep normocapnia, normoxemia, and normothermia. Based on routine blood gas analysis, hemoglobin, PaCO
2,
and PaO
2
data were matched to 2-h averaged data of continuous CPP, P
bt
O
2
, core temperature, and to hourly cerebral microdialysis (CMD) samples over the first 11 days.
Results
Patients had a Glasgow Coma Scale of 3 (IQR 3–4) and were 58 years old (IQR 48–66). Overall incidence of brain tissue hypoxia was 25%, which was not different between both sites despite differences in the treatment approach. During brain tissue hypoxia, episodes of CPP < 70 mmHg (27%), PaCO
2
< 35 mmHg (19%), PaO
2
< 80 mmHg (14%), Hb < 9 g/dL (11%), metabolic crisis (CMD-lactate/pyruvate ratio > 40, and CMD-glucose < 0.7 mmol/L; 7%), and temperature > 38.3 °C (4%) were common.
Conclusions
Our results demonstrate that brain tissue hypoxia remains common despite implementation of a P
bt
O
2
-targeted therapy in poor-grade SAH patients, suggesting room for further optimization.]]></description><identifier>ISSN: 1541-6933</identifier><identifier>EISSN: 1556-0961</identifier><identifier>DOI: 10.1007/s12028-019-00753-0</identifier><identifier>PMID: 31218640</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Anesthesia ; Blood ; Blood gas analysis ; Brain - metabolism ; Carbon Dioxide ; Catheters ; Cerebrovascular Circulation ; Clinical Protocols ; Cohort Studies ; Critical Care Medicine ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Glucose - metabolism ; Hemoglobin ; Humans ; Hypoxia ; Hypoxia, Brain - metabolism ; Hypoxia, Brain - prevention & control ; Hypoxia, Brain - therapy ; Intensive ; Internal Medicine ; Intracranial pressure ; Lactic Acid - metabolism ; Male ; Medicine ; Medicine & Public Health ; Microdialysis ; Middle Aged ; Neurology ; Optimization ; Original Work ; Oxygen - metabolism ; Oxygen Inhalation Therapy - methods ; Partial Pressure ; Patients ; Pyruvic Acid - metabolism ; Respiration, Artificial - methods ; Stroke ; Subarachnoid Hemorrhage - metabolism ; Subarachnoid Hemorrhage - therapy ; Traumatic brain injury ; Variables</subject><ispartof>Neurocritical care, 2019-10, Vol.31 (2), p.263-272</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-f47b839dcc401c768605391a9f2d76e062e87ac8a2e30dc448d7f484342abbd33</citedby><cites>FETCH-LOGICAL-c474t-f47b839dcc401c768605391a9f2d76e062e87ac8a2e30dc448d7f484342abbd33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12028-019-00753-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2919544511?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,776,780,881,21368,21369,27903,27904,33509,33510,33723,33724,41467,42536,43638,43784,51297,64361,64363,64365,72215</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31218640$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rass, Verena</creatorcontrib><creatorcontrib>Solari, Daria</creatorcontrib><creatorcontrib>Ianosi, Bogdan</creatorcontrib><creatorcontrib>Gaasch, Max</creatorcontrib><creatorcontrib>Kofler, Mario</creatorcontrib><creatorcontrib>Schiefecker, Alois J.</creatorcontrib><creatorcontrib>Miroz, John-Paul</creatorcontrib><creatorcontrib>Morelli, Paola</creatorcontrib><creatorcontrib>Thomé, Claudius</creatorcontrib><creatorcontrib>Beer, Ronny</creatorcontrib><creatorcontrib>Pfausler, Bettina</creatorcontrib><creatorcontrib>Oddo, Mauro</creatorcontrib><creatorcontrib>Helbok, Raimund</creatorcontrib><title>Protocolized Brain Oxygen Optimization in Subarachnoid Hemorrhage</title><title>Neurocritical care</title><addtitle>Neurocrit Care</addtitle><addtitle>Neurocrit Care</addtitle><description><![CDATA[Background
Brain tissue hypoxia (P
bt
O
2
< 20 mmHg) is common after subarachnoid hemorrhage (SAH) and associated with poor outcome. Recent data suggest that brain oxygen optimization is feasible and reduces the time spent with P
bt
O
2
< 20 mmHg from 45 to 16% in patients with severe traumatic brain injury. Here, we intended to quantify the brain tissue hypoxia burden despite implementation of a protocolized treatment approach in poor-grade SAH patients and to identify the simultaneous occurrence of pathologic values potentially amenable to treatment.
Methods
We present a bi-centric observational cohort study including 100 poor-grade SAH patients admitted to two tertiary care centers who underwent multimodal brain monitoring and were managed with a P
bt
O
2
-targeted protocolized approach. P
bt
O
2
optimization (≥ 20 mmHg) included a stepwise neuro-intensive care approach, aiming to prevent low cerebral perfusion pressure (CPP), and blood hemoglobin, and to keep normocapnia, normoxemia, and normothermia. Based on routine blood gas analysis, hemoglobin, PaCO
2,
and PaO
2
data were matched to 2-h averaged data of continuous CPP, P
bt
O
2
, core temperature, and to hourly cerebral microdialysis (CMD) samples over the first 11 days.
Results
Patients had a Glasgow Coma Scale of 3 (IQR 3–4) and were 58 years old (IQR 48–66). Overall incidence of brain tissue hypoxia was 25%, which was not different between both sites despite differences in the treatment approach. During brain tissue hypoxia, episodes of CPP < 70 mmHg (27%), PaCO
2
< 35 mmHg (19%), PaO
2
< 80 mmHg (14%), Hb < 9 g/dL (11%), metabolic crisis (CMD-lactate/pyruvate ratio > 40, and CMD-glucose < 0.7 mmol/L; 7%), and temperature > 38.3 °C (4%) were common.
Conclusions
Our results demonstrate that brain tissue hypoxia remains common despite implementation of a P
bt
O
2
-targeted therapy in poor-grade SAH patients, suggesting room for further optimization.]]></description><subject>Aged</subject><subject>Anesthesia</subject><subject>Blood</subject><subject>Blood gas analysis</subject><subject>Brain - metabolism</subject><subject>Carbon Dioxide</subject><subject>Catheters</subject><subject>Cerebrovascular Circulation</subject><subject>Clinical Protocols</subject><subject>Cohort Studies</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Glasgow Outcome Scale</subject><subject>Glucose - metabolism</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Hypoxia, Brain - metabolism</subject><subject>Hypoxia, Brain - prevention & control</subject><subject>Hypoxia, Brain - therapy</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Intracranial pressure</subject><subject>Lactic Acid - metabolism</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microdialysis</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Optimization</subject><subject>Original Work</subject><subject>Oxygen - metabolism</subject><subject>Oxygen Inhalation Therapy - methods</subject><subject>Partial Pressure</subject><subject>Patients</subject><subject>Pyruvic Acid - metabolism</subject><subject>Respiration, Artificial - methods</subject><subject>Stroke</subject><subject>Subarachnoid Hemorrhage - metabolism</subject><subject>Subarachnoid Hemorrhage - therapy</subject><subject>Traumatic brain injury</subject><subject>Variables</subject><issn>1541-6933</issn><issn>1556-0961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtLxDAQx4Movr-AB1nw4qU6eTRpLoIuvkBQUM8hTdPdSNusSSvqpzfr-j54mpnMb_6T4Y_QDoYDDCAOIyZAigywzFKZ0wyW0DrOc56B5Hh5njOccUnpGtqI8QGACCnyVbRGMcEFZ7COjm-C773xjXu11egkaNeNrp9fJjaFWe9a96p757tRer4dSh20mXbeVaML2_oQpnpit9BKrZtotz_iJro_O70bX2RX1-eX4-OrzDDB-qxmoiyorIxhgI3gBYecSqxlTSrBLXBiC6FNoYmlUBnGikrUrGCUEV2WFaWb6GihOxvK1lbGdn3QjZoF1-rworx26nenc1M18U-Ki1wA4Ulg_0Mg-MfBxl61LhrbNLqzfoiKEMYwAyrn6N4f9MEPoUvnKSKxzBnLMU4UWVAm-BiDrb8-g0HNHVILh1RySL07pCAN7f4842vk05IE0AUQU6ub2PC9-x_ZN8HTnAM</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Rass, Verena</creator><creator>Solari, Daria</creator><creator>Ianosi, Bogdan</creator><creator>Gaasch, Max</creator><creator>Kofler, Mario</creator><creator>Schiefecker, Alois J.</creator><creator>Miroz, John-Paul</creator><creator>Morelli, Paola</creator><creator>Thomé, Claudius</creator><creator>Beer, Ronny</creator><creator>Pfausler, Bettina</creator><creator>Oddo, Mauro</creator><creator>Helbok, Raimund</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20191001</creationdate><title>Protocolized Brain Oxygen Optimization in Subarachnoid Hemorrhage</title><author>Rass, Verena ; Solari, Daria ; Ianosi, Bogdan ; Gaasch, Max ; Kofler, Mario ; Schiefecker, Alois J. ; Miroz, John-Paul ; Morelli, Paola ; Thomé, Claudius ; Beer, Ronny ; Pfausler, Bettina ; Oddo, Mauro ; Helbok, Raimund</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-f47b839dcc401c768605391a9f2d76e062e87ac8a2e30dc448d7f484342abbd33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Blood</topic><topic>Blood gas analysis</topic><topic>Brain - metabolism</topic><topic>Carbon Dioxide</topic><topic>Catheters</topic><topic>Cerebrovascular Circulation</topic><topic>Clinical Protocols</topic><topic>Cohort Studies</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Glasgow Outcome Scale</topic><topic>Glucose - metabolism</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hypoxia</topic><topic>Hypoxia, Brain - metabolism</topic><topic>Hypoxia, Brain - prevention & control</topic><topic>Hypoxia, Brain - therapy</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Intracranial pressure</topic><topic>Lactic Acid - metabolism</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microdialysis</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Optimization</topic><topic>Original Work</topic><topic>Oxygen - metabolism</topic><topic>Oxygen Inhalation Therapy - methods</topic><topic>Partial Pressure</topic><topic>Patients</topic><topic>Pyruvic Acid - metabolism</topic><topic>Respiration, Artificial - methods</topic><topic>Stroke</topic><topic>Subarachnoid Hemorrhage - metabolism</topic><topic>Subarachnoid Hemorrhage - therapy</topic><topic>Traumatic brain injury</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rass, Verena</creatorcontrib><creatorcontrib>Solari, Daria</creatorcontrib><creatorcontrib>Ianosi, Bogdan</creatorcontrib><creatorcontrib>Gaasch, Max</creatorcontrib><creatorcontrib>Kofler, Mario</creatorcontrib><creatorcontrib>Schiefecker, Alois J.</creatorcontrib><creatorcontrib>Miroz, John-Paul</creatorcontrib><creatorcontrib>Morelli, Paola</creatorcontrib><creatorcontrib>Thomé, Claudius</creatorcontrib><creatorcontrib>Beer, Ronny</creatorcontrib><creatorcontrib>Pfausler, Bettina</creatorcontrib><creatorcontrib>Oddo, Mauro</creatorcontrib><creatorcontrib>Helbok, Raimund</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurocritical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rass, Verena</au><au>Solari, Daria</au><au>Ianosi, Bogdan</au><au>Gaasch, Max</au><au>Kofler, Mario</au><au>Schiefecker, Alois J.</au><au>Miroz, John-Paul</au><au>Morelli, Paola</au><au>Thomé, Claudius</au><au>Beer, Ronny</au><au>Pfausler, Bettina</au><au>Oddo, Mauro</au><au>Helbok, Raimund</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Protocolized Brain Oxygen Optimization in Subarachnoid Hemorrhage</atitle><jtitle>Neurocritical care</jtitle><stitle>Neurocrit Care</stitle><addtitle>Neurocrit Care</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>31</volume><issue>2</issue><spage>263</spage><epage>272</epage><pages>263-272</pages><issn>1541-6933</issn><eissn>1556-0961</eissn><abstract><![CDATA[Background
Brain tissue hypoxia (P
bt
O
2
< 20 mmHg) is common after subarachnoid hemorrhage (SAH) and associated with poor outcome. Recent data suggest that brain oxygen optimization is feasible and reduces the time spent with P
bt
O
2
< 20 mmHg from 45 to 16% in patients with severe traumatic brain injury. Here, we intended to quantify the brain tissue hypoxia burden despite implementation of a protocolized treatment approach in poor-grade SAH patients and to identify the simultaneous occurrence of pathologic values potentially amenable to treatment.
Methods
We present a bi-centric observational cohort study including 100 poor-grade SAH patients admitted to two tertiary care centers who underwent multimodal brain monitoring and were managed with a P
bt
O
2
-targeted protocolized approach. P
bt
O
2
optimization (≥ 20 mmHg) included a stepwise neuro-intensive care approach, aiming to prevent low cerebral perfusion pressure (CPP), and blood hemoglobin, and to keep normocapnia, normoxemia, and normothermia. Based on routine blood gas analysis, hemoglobin, PaCO
2,
and PaO
2
data were matched to 2-h averaged data of continuous CPP, P
bt
O
2
, core temperature, and to hourly cerebral microdialysis (CMD) samples over the first 11 days.
Results
Patients had a Glasgow Coma Scale of 3 (IQR 3–4) and were 58 years old (IQR 48–66). Overall incidence of brain tissue hypoxia was 25%, which was not different between both sites despite differences in the treatment approach. During brain tissue hypoxia, episodes of CPP < 70 mmHg (27%), PaCO
2
< 35 mmHg (19%), PaO
2
< 80 mmHg (14%), Hb < 9 g/dL (11%), metabolic crisis (CMD-lactate/pyruvate ratio > 40, and CMD-glucose < 0.7 mmol/L; 7%), and temperature > 38.3 °C (4%) were common.
Conclusions
Our results demonstrate that brain tissue hypoxia remains common despite implementation of a P
bt
O
2
-targeted therapy in poor-grade SAH patients, suggesting room for further optimization.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>31218640</pmid><doi>10.1007/s12028-019-00753-0</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1541-6933 |
| ispartof | Neurocritical care, 2019-10, Vol.31 (2), p.263-272 |
| issn | 1541-6933 1556-0961 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6757026 |
| source | MEDLINE; ProQuest Central (Alumni Edition); Springer Nature - Complete Springer Journals; ProQuest Central UK/Ireland; ProQuest Central |
| subjects | Aged Anesthesia Blood Blood gas analysis Brain - metabolism Carbon Dioxide Catheters Cerebrovascular Circulation Clinical Protocols Cohort Studies Critical Care Medicine Female Glasgow Coma Scale Glasgow Outcome Scale Glucose - metabolism Hemoglobin Humans Hypoxia Hypoxia, Brain - metabolism Hypoxia, Brain - prevention & control Hypoxia, Brain - therapy Intensive Internal Medicine Intracranial pressure Lactic Acid - metabolism Male Medicine Medicine & Public Health Microdialysis Middle Aged Neurology Optimization Original Work Oxygen - metabolism Oxygen Inhalation Therapy - methods Partial Pressure Patients Pyruvic Acid - metabolism Respiration, Artificial - methods Stroke Subarachnoid Hemorrhage - metabolism Subarachnoid Hemorrhage - therapy Traumatic brain injury Variables |
| title | Protocolized Brain Oxygen Optimization in Subarachnoid Hemorrhage |
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