[Clinical evaluation of neurogenic pulmonary edema following acute stage of subarachnoid hemorrhage].
Clinical characteristics and therapeutic problems of neurogenic pulmonary edema (NPE) occurring in the acute stage of severe subarachnoid hemorrhage (SAH) were examined. The relationship between SAH and NPE was studied in 208 patients who arrived at the hospital in the acute stage (within 24 hours after the onset) of severe SAH in the past nine years. NPE was observed in four (6%) of 64 Grade III patients, nine (18%) of 49 Grade IV patients and 20 (21%) of 95 Grade V patients. Higher grade patients tended to be complicated by NPE more frequently. CT findings of these 33 patients with NPE belonged to Fisher's Group 3 or 4 (23 of 110 group-3 patients and 10 of 88 group-4 patients). Concerning ECG abnormalities, depression of ST segment, abnormal T waves, sinus tachycardia, and right bundle-branch block were observed more frequently in the NPE group than in the non-NPE group. In comparison of the age, blood pressure, PaO2, serum electrolyte, WBC, and blood sugar level on admission between the two groups, significantly higher values of diastolic pressure and blood sugar levels were shown in the NPE group than non-NPE group. The mean interval between the onset of SAH and the diagnosis of NPE on chest film was 2.5 hours, while the NPE findings disappeared within three days after the onset of SAH (mean 1.2 days). In all cases, the NPE findings disappeared after a variety of respiratory managements had been carried out.(ABSTRACT TRUNCATED AT 250 WORDS)
Watanabe
T
T
Department of Neurosurgery, Yamagata Prefectural Central Hospital, Japan.
Sekiguchi
K
K
Inoue
A
A
Taniguchi
Y
Y
Sato
S
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011379:Prognosis; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy; D012121:Respiration, Artificial; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000150:complications*