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Circulatory volume expansion for aneurysmal subarachnoid hemorrhage
V L Feigin1, G J Rinkel, A Algra
1Department of Neurology, University Hospital Utrecht, PO Box 85500, Utrecht, Netherlands, 3508 GA. g.j.e.rinkel@neuro.azu.nl
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Volume expansion therapy for subarachnoid hemorrhage is not well-studied. Current evidence does not support or refute its use in preventing delayed cerebral ischemia and neurological disability.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Subarachnoid hemorrhage (SAH) can lead to cerebral artery spasm and delayed cerebral ischemia (DCI).
- Reduced circulatory volume may worsen DCI risk in SAH patients.
- Intravenous fluid therapy (volume expansion) is a potential intervention to mitigate DCI and neurological deficits.
Purpose of the Study:
- To review existing evidence on the efficacy of volume expansion therapy in improving outcomes for patients with aneurysmal subarachnoid hemorrhage.
Main Methods:
- Searched the Cochrane Stroke Group's Specialized Register (up to March 1999) for relevant trials.
- Included all randomized controlled trials (RCTs) evaluating volume expansion therapy in aneurysmal SAH.
- Two independent reviewers extracted data and assessed trial quality, contacting trialists for missing information.
Main Results:
- Only two trials were identified.
- One trial's inclusion is pending due to incomplete follow-up data.
- The other trial assessed outcomes early (7-10 days post-SAH) without long-term follow-up data.
Conclusions:
- The impact of volume expansion therapy in aneurysmal SAH remains inadequately studied.
- There is currently no robust evidence to support or oppose its use.
- Further high-quality research is needed to establish the role of volume expansion therapy in managing SAH.