Key result
Vigorous plasma volume expansion significantly improved overall outcome (P=0.006) and decreased delayed cerebral ischemia (P=0.00005) compared to fluid restriction in patients with aneurysmal SAH.
Why the study?
Does hypervolemic hemodilution and avoidance of fluid restriction/antihypertensives improve outcomes in patients with aneurysmal subarachnoid hemorrhage compared to fluid restriction and antihypertensive therapy?
Population
348 patients admitted within 72 hours after aneurysmal subarachnoid hemorrhage. Excluded: negative…
Comparison
Medical management from 1989-1992: daily fluid… vs Medical management from 1977-1982: max daily…
Design
Cohort
Authors
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May support hypervolemia over restriction in aneurysmal SAH; hypothesis-generating and requires randomized confirmation.
Cohort (n=348)
No
Does hypervolemic hemodilution and avoidance of fluid restriction/antihypertensives improve outcomes in patients with aneurysmal subarachnoid hemorrhage compared to fluid restriction and antihypertensive therapy?
p-value: p=0.006
A shift in medical management towards hypervolemia and avoidance of antihypertensives significantly reduced delayed cerebral ischemia and improved overall outcomes in patients with aneurysmal subarachnoid hemorrhage.
Vermeij et al. (1998) conducted a cohort in Aneurysmal Subarachnoid Hemorrhage (n=348). Vigorous plasma volume expansion and avoidance of antihypertensives/diuretics vs. Fluid restriction and antihypertensive treatment was evaluated on Overall outcome (p=0.006). Vigorous plasma volume expansion significantly improved overall outcome (P=0.006) and decreased delayed cerebral ischemia (P=0.00005) compared to fluid restriction in patients with aneurysmal SAH.
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