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Gastric tonometry after subarachnoid hemorrhage.
T Koivisto1, M Vapalahti, I Parviainen
1Department of Neurosurgery, Kuopio University Hospital, Puijonlaaksontie 2, SF-70211 Kuopio, Finland. timo.koivisto@kuh.fi
Intensive Care Medicine
|October 31, 2001
Summary
Splanchnic tissue perfusion may be compromised in subarachnoid hemorrhage (SAH) patients despite normal hemodynamics. Treatment and SAH severity did not correlate with specific gastric intramucosal-arterial pCO2 differences, indicating potential for undetected perfusion issues.
Area of Science:
- Neurology
- Critical Care Medicine
- Gastroenterology
Background:
- Subarachnoid hemorrhage (SAH) can lead to complex physiological disturbances.
- Assessing splanchnic tissue perfusion is crucial for managing SAH patients.
- Gastric tonometry offers a method to evaluate splanchnic perfusion indirectly.
Purpose of the Study:
- To evaluate splanchnic tissue perfusion in SAH patients using gastric tonometry.
- To investigate the impact of surgical versus endovascular treatment on splanchnic perfusion.
- To determine if initial SAH severity influences splanchnic tissue perfusion.
Main Methods:
- Prospective observational substudy within a randomized controlled trial.
- Inclusion of 26 SAH patients treated within 72 hours.
- Gastric tonometry (pCO2 gap and pH) measured post-aneurysm treatment.
Main Results:
- No significant changes in gastric intramucosal-arterial pCO2 difference (pCO2 gap) or gastric intramucosal pH were observed.
- No differences in pCO2 gap or pH were found between surgical and endovascular treatment groups.
- No differences were noted between different Hunt & Hess grades of SAH severity.
Conclusions:
- Splanchnic tissue perfusion may be inadequate in SAH patients even without systemic hemodynamic compromise.
- Neither the treatment modality nor the initial SAH severity predicted specific patterns of splanchnic perfusion.
- Gastric tonometry may reveal occult splanchnic hypoperfusion in SAH.