Safety and efficacy of magnesium-rich artificial cerebrospinal fluid for subarachnoid hemorrhage

Autor: Yawen Cheng, Xiangning Han, Wanfu Xie, Gaofeng Xu, Xiaobin Bai, Lei Qi, Linjuan Zhang, Rui Liu, Weihua Dong, Weiyi Feng, Chengsen Pang, Wei Zhang, Fude Liu, Xiangqi Cao, Yue Xu, Guogang Luo
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Frontiers in Neurology, Vol 15 (2024)
Druh dokumentu: article
ISSN: 1664-2295
DOI: 10.3389/fneur.2024.1376216
Popis: ObjectivesThis study aimed to investigate the efficacy of using a newly formulated magnesium-rich artificial cerebrospinal fluid (MACSF) as an alternative to normal saline (NS) for intraoperative irrigation during aneurysm clipping in improving the prognosis of patients with Aneurysmal subarachnoid hemorrhage (aSAH).MethodsPatients with aSAH who underwent intraoperative irrigation with MACSF or NS during the clipping in the First Affiliated Hospital of Xi ‘an Jiaotong University from March 2019 to March 2022 were selected as MACSF group and NS group, respectively. The primary prognostic indicators were the incidence of favorable outcomes (mRS 0–2). The secondary outcome measures included cerebral vasospasm (CVS), mortality, total hospital stay, and intensive care unit (ICU) stay. Safety was evaluated based on the occurrence rates of hypermagnesemia, meningitis, and hydrocephalus.ResultsOverall, 34 and 37 patients were enrolled in the MACSF and NS groups, respectively. At 90 days after aSAH onset, the proportion of favorable prognosis in the MACSF group was significantly higher than that in the NS group (p = 0.035). The incidence of CVS within 14 days after surgery was significantly lower in the MACSF group than that in the NS group (p = 0.026). The mortality rate in the MACSF group was significantly lower than in the NS group (p = 0.048). The median lengths of hospital stay (p = 0.008) and ICU stay (p = 0.018) were significantly shorter in the MACSF group than in the NS group. No significant differences were observed in safety measures.ConclusionUsing MACSF as an irrigation fluid for aneurysm clipping can significantly improve the 90-day prognosis of patients with aSAH, which may be related to the reduced incidence of CVS.Clinical trial registrationhttps://www.clinicaltrials.gov, identifier NCT04358445.
Databáze: Directory of Open Access Journals