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Báo cáo y học: "Effect of different components of triple-H therapy on cerebral perfusion in patients with aneurysmal subarachnoid haemorrhage: a systematic review"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Effect of different components of triple-H therapy on cerebral perfusion in patients with aneurysmal subarachnoid haemorrhage: a systematic review. | Dankbaar et al. Critical Care 2010 14 R23 http ccforum.eom content 14 1 R23 c CRITICAL CARE RESEARCH Open Access Effect of different components of triple-H therapy on cerebral perfusion in patients with aneurysmal subarachnoid haemorrhage a systematic review Jan W Dankbaar1 Arjen JC Slooter2 Gabriel JE Rinkel3 Irene C van der Schaaf1 Abstract Introduction Triple-H therapy and its separate components hypervolemia hemodilution and hypertension aim to increase cerebral perfusion in subarachnoid haemorrhage SAH patients with delayed cerebral ischemia. We systematically reviewed the literature on the effect of triple-H components on cerebral perfusion in SAH patients. Methods We searched medical databases to identify all articles until October 2009 except case reports on treatment with triple-H components in SAH patients with evaluation of the treatment using cerebral blood flow CBF in ml 100 g min measurement. We summarized study design patient and intervention characteristics and calculated differences in mean CBF before and after intervention. Results Eleven studies 4 to 51 patients per study were included one randomized trial . Hemodilution did not change CBF. One of seven studies on hypervolemia showed statistically significant CBF increase compared to baseline there was no comparable control group. Two of four studies applying hypertension and one of two applying triple-H showed significant CBF increase none used a control group. The large heterogeneity in interventions and study populations prohibited meta-analyses. Conclusions There is no good evidence from controlled studies for a positive effect of triple-H or its separate components on CBF in SAH patients. In uncontrolled studies hypertension seems to be more effective in increasing CBF than hemodilution or hypervolemia. Introduction Aneurysmal subarachnoid haemorrhage SAH is a subset of stroke that occurs at a relatively young age median 55 years and has a high rate of morbidity 25 and case fatality 35 1 . .