Hypertensive, hypervolemic, hemodilutional therapy for aneurysmal subarachnoid hemorrhage. Is it efficacious? No.
Many neurosurgeons routinely use hypertensive, hypervolemic, hemodilutional, or hyperdynamic therapy (HT) in some form to prevent or to treat vasospasm. Despite the widespread use of this therapy during the past 20 years, however, there are no randomized, prospective, controlled clinical studies demonstrating that HT improves the short- or long-term neurologic outcome or survival after subarachnoid hemorrhage. Guidelines need to be developed to standardize the clinical application of HT, and well-controlled, prospective, randomized clinical trials must be conducted before HT can become an accepted treatment for vasospasm.
Oropello
J M
JM
Department of Surgery, Mount Sinai Medical Center, City University of New York, New York, USA.
Weiner
L
L
Benjamin
E
E
D001794:Blood Pressure; D019317:Evidence-Based Medicine; D005440:Fluid Therapy / Q000592:standards*; D006438:Hemodilution / Q000592:standards*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D002546:Ischemic Attack, Transient / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D012107:Research Design; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D016896:Treatment Outcome