Aneurysmal Subarachnoid Hemorrhage, Subarachnoid Hemorrhage
Conditions
Keywords
perfusion, isofluorane, inhalatory, sedation
Brief summary
The aim of this study is to evaluate the effect of inhalational sedation on cerebral perfusion in patients with SAH. It will evaluate whether the administration of isofluorane, by inducing direct vasodilation in the cerebral parenchyma, can improve the cerebral perfusion rates. Perfusional CT will be used to study the variation of cerebral blood flow to rule out the vasodilatory effect on territories with different cerebrovascular reactivity aggravating the phenomena of distrectual hypoperfusion (theft theory).
Interventions
DRUGIsoflurane Inhal Soln
Administration of isofluorane in patients with severe SAH
Sponsors
A.O.U. Città della Salute e della Scienza
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 64 Years
Healthy volunteers
No
Inclusion criteria
* Age \> 18 years old * Diagnosis of non-traumatic SAH * Neurological and/or systemic presentation that requires support of vital functions and sedation. This occurs for a WFNS score (World Federation of Neurosurgical Societies) ≥ 3. * Possibility of ICP monitoring through EVD which is necessary in case of acute hydrocephalous. In case of the neurosurgeon do not indicate the positioning of the EVD, an intraparenchymal catheter will be positioned for the ICP monitoring. * Patients with vasospasm (area of cerebral blood flow under 30% of the best value detected in the brain of the patients at the first CT scan). This exam will be performed at 2° - 3° day post event. * Acceptance of informed consent.
Exclusion criteria
* Documented outcomes of cerebrovascular disease * Patients with acute heart failure related to ESA * State of pregnancy * Patients with CLCR \< 30 mL/min
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cerebral blood flow recondtion | 20 minutes | The percentage of subjects who had a flow recondition at the second CT at least 50% of the best value detected in the first perfusion CT scan |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in intracranial pressure during isoflurane delivery | 20 minutes | We evaluate if isofluorane create an increase in ICP trough continuous monitoring. |
| Changes in blood pressure during isoflurane delivery | 20 minutes | By its vasodilatatore effect, we monitored punctually if mean arterial blood pressure will increase during isofluorane delivery |
Countries
Italy
Outcome results
None listed