Microvascular cerebral blood flow response to intrathecal nicardipine is associated with delayed cerebral ischemia.

Autor:	Sathialingam E; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States., Cowdrick KR; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States., Liew AY; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States., Fang Z; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States., Lee SY; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States.; Department of Electrical and Computer Engineering, Kennesaw State University, Marietta, GA, United States., McCracken CE; Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, United States., Akbik F; Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States., Samuels OB; Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States., Kandiah P; Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States., Sadan O; Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States., Buckley EM; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States.; Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, United States.; Children's Research Scholar, Children's Healthcare of Atlanta, Atlanta, GA, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2023 Mar 17; Vol. 14, pp. 1052232. Date of Electronic Publication: 2023 Mar 17 (Print Publication: 2023).
DOI:	10.3389/fneur.2023.1052232
Abstrakt:	One of the common complications of non-traumatic subarachnoid hemorrhage (SAH) is delayed cerebral ischemia (DCI). Intrathecal (IT) administration of nicardipine, a calcium channel blocker (CCB), upon detection of large-artery cerebral vasospasm holds promise as a treatment that reduces the incidence of DCI. In this observational study, we prospectively employed a non-invasive optical modality called diffuse correlation spectroscopy (DCS) to quantify the acute microvascular cerebral blood flow (CBF) response to IT nicardipine (up to 90 min) in 20 patients with medium-high grade non-traumatic SAH. On average, CBF increased significantly with time post-administration. However, the CBF response was heterogeneous across subjects. A latent class mixture model was able to classify 19 out of 20 patients into two distinct classes of CBF response: patients in Class 1 ( n = 6) showed no significant change in CBF, while patients in Class 2 ( n = 13) showed a pronounced increase in CBF in response to nicardipine. The incidence of DCI was 5 out of 6 in Class 1 and 1 out of 13 in Class 2 ( p < 0.001). These results suggest that the acute (<90 min) DCS-measured CBF response to IT nicardipine is associated with intermediate-term (up to 3 weeks) development of DCI. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Sathialingam, Cowdrick, Liew, Fang, Lee, McCracken, Akbik, Samuels, Kandiah, Sadan and Buckley.)
Databáze:	MEDLINE
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