Effect of intrathecal milrinone injection via lumbar catheter on delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage
| Autor: | Masaki Chin, Masaomi Koyanagi, Yoshitaka Kurosaki, Sen Yamagata, Nobutake Sadamasa, Benjamin Lo, Minami Uezato, Hitoshi Fukuda, Akira Handa |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Catheters Subarachnoid hemorrhage Vasodilator Agents Ischemia Brain Ischemia 03 medical and health sciences 0302 clinical medicine medicine Humans Vasospasm Intracranial Injections Spinal Aged business.industry Vasospasm General Medicine Middle Aged Subarachnoid Hemorrhage medicine.disease Hydrocephalus Catheter Treatment Outcome 030220 oncology & carcinogenesis Anesthesia Heart failure Milrinone Female Complication business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Neurosurgery. 128:717-722 |
| ISSN: | 1933-0693 0022-3085 |
| DOI: | 10.3171/2016.10.jns162227 |
| Popis: | OBJECTIVEDelayed cerebral ischemia (DCI) is an important complication after aneurysmal subarachnoid hemorrhage (aSAH). Although intrathecal milrinone injection via lumbar catheter to prevent DCI has been previously reported to be safe and feasible, its effectiveness remains unknown. The goal of this study was to evaluate whether intrathecal milrinone injection treatment after aSAH significantly reduced the incidence of DCI.METHODSThe prospectively maintained aSAH database was used to identify patients treated between January 2010 and December 2015. The cohort included 274 patients, with group assignment based on treatment with intrathecal milrinone injection or not. A propensity score model was generated for each patient group, incorporating relevant patient variables.RESULTSAfter propensity score matching, 99 patients treated with intrathecal milrinone injection and 99 without treatment were matched on the basis of similarities in their demographic and clinical characteristics. There were significantly fewer DCI events (4% vs 14%, p = 0.024) in patients treated with intrathecal milrinone injection compared with those treated without it. However, there were no significant differences between the 2 groups with respect to their 90-day functional outcomes (46% vs 36%, p = 0.31). The likelihood of chronic secondary hydrocephalus, meningitis, and congestive heart failure as complications of intrathecal milrinone injection therapy was also similar between the groups.CONCLUSIONSIn propensity score–matched groups, the intrathecal administration of milrinone via lumbar catheter showed significant reduction of DCI following aSAH, without an associated increase in complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|