Pulmonary edema and cardiac dysfunction following subarachnoid hemorrhage.
BACKGROUND
Pulmonary edema (PE) can occur in the early or late period following subarachnoid hemorrhage (SAH). The incidence of each type of PE is unknown and the association with ventricular dysfunction, both systolic and diastolic, has not been described.


METHODS
Retrospective chart review of 178 consecutive patients with SAH surgically treated over a three-year period. Patients with pulmonary edema diagnosed by a radiologist were included. Early onset SAH was defined as occurring within 12 hours. Cardiac function at the time of the PE was analyzed using hemodynamic and echocardiographic criteria of systolic and diastolic dysfunction. Pulmonary edema was observed in 42 patients (28.8%) and was more often delayed (89.4%). Evidence of cardiac involvement during PE varied between 40 to 100%.


CONCLUSIONS
Pulmonary edema occurs in 28.8% of patients after SAH, and is most commonly delayed. Cardiac dysfunction, both systolic and diastolic, is commonly observed during SAH and could contribute to the genesis of PE after SAH.
McLaughlin
Nancy
N
Department of Neurosurgery, Centre Hospitalier de l'Université de Montréal-Hôpital Notre-Dame, QC, Canada.
Bojanowski
Michel W
MW
Girard
François
F
Denault
André
A
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D015897:Comorbidity; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006321:Heart / Q000294:innervation / Q000503:physiopathology; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D011654:Pulmonary Edema / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors