Cardiac performance enhancement and hypervolemic therapy.
This article discusses guidelines the authors have established in managing patients with ruptured intracranial aneurysms and associated vasospasm. These guidelines represent methods of improving cardiac output or the ideal cardiac indices, to improve or maximize cerebral blood flow and potentially improve outcome. The guidelines for hypervolemic therapy for the volume and timing of intravenous fluid administration and the target cardiac performance parameters also are discussed.
Levy
M L
ML
Department of Anesthesia, University of Southern California School of Medicine, Los Angeles.
Day
J D
JD
Zelman
V
V
Giannotta
S L
SL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001809:Blood Viscosity / Q000187:drug effects / Q000502:physiology; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology; D002545:Brain Ischemia / Q000503:physiopathology / Q000628:therapy; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D003422:Critical Care; D004280:Dobutamine / Q000008:administration & dosage; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006438:Hemodilution; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000503:physiopathology / Q000601:surgery*; D002546:Ischemic Attack, Transient / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy*; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology / Q000601:surgery*
D004280:Dobutamine