Fluid Balance and Blood Volume Measurement after Aneurysmal Subarachnoid Hemorrhage

Hoff, Reinier G.; Dijk, Gert W van; Algra, Ale; Kalkman, Cor J.; Rinkel, Gabriël J.E.

doi:10.1007/s12028-007-9043-x

Cited by 46 publications

(47 citation statements)

References 32 publications

(35 reference statements)

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“…This is in contrast with the hypothesis that BNP would lead to urinary sodium and water excretion as seen in CSW. Previous studies have shown that fluid balances are not correlated to actual circulating blood volume, what can explain why the authors found high BNP concentrations associated with severe hypovolemia measured with PDD, but not with more urine production or lower fluid balances [12]. Several reports found CSW to be the most common cause of hyponatremia after intracranial disease, including SAH [3,7,13,[26][27][28].…”

Section: Discussionmentioning

confidence: 93%

“…In CSW, patients are hyponatremic due to active urinary sodium excretion and not to water retention and patient are therefore hypovolemic. The key feature to differentiate between the two syndromes is volume status, but circulatory volume status is very difficult to assess on clinical or biochemical grounds [11,12]. Outside the context of SAH, SIADH is treated by fluid restriction and CSW by sodium and fluid replacement.…”

Section: Introductionmentioning

confidence: 99%

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Brain Natriuretic Peptide Concentrations After Aneurysmal Subarachnoid Hemorrhage: Relationship with Hypovolemia and Hyponatremia

et al. 2011

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Brain Natriuretic Peptide Concentrations After Aneurysmal Subarachnoid Hemorrhage: Relationship with Hypovolemia and Hyponatremia

et al. 2011

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“…2,6,7 BV values were classified as normal (60 to 80 mL/kg), moderate hypovolemic (50 to 60 mL/kg), severe hypovolemic (Ͻ50 mL/kg), or hypervolemic (Ͼ80 mL/kg). 6,8 The goal of fluid management was to maintain normovolemia. At admission, an infusion of 3 L normal saline per day was installed, in addition to oral intake as desired by the patient.…”

Section: Methodsmentioning

confidence: 99%

Blood Volume Measurement to Guide Fluid Therapy After Aneurysmal Subarachnoid Hemorrhage

Hoff

Rinkel

Verweij

et al. 2009

Stroke

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Background and Purpose-Conventional parameters used to guide fluid therapy after aneurysmal subarachnoid hemorrhage (SAH) are poorly related to blood volume. In a prospective controlled study we assessed whether fluid management guided by daily measurements of blood volume (BV) reduces the incidence of severe hypovolemia compared to conventional fluid balance guided fluid therapy. Methods-We used Pulse Dye Densitometry to measure BV daily in 102 patients during the first 10 days after SAH. Fluid management was based on BV-measurements in the intervention group (nϭ54) and on fluid balance in the control group (nϭ48). Severe hypovolemia was defined as BV Ͻ50 mL/kg. Results-In the intervention group 6.7% of BV measurements were in the severe hypovolemic range and in the control group 17.1% (mean weighted difference 7.7%; 95% CI: 1.4 to 13.9%). In the intervention group 21 patients (39%) had 1 or more measurements with severe hypovolemia versus 26 (54%) of the controls (RR 0.7; 95% CI: 0.5 to 1.1). Conclusions-Guiding fluid management on daily measurements of blood volume reduces the incidence of severe hypovolemia after SAH. The effects on neurological outcome should be studied.

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“…Fluid balance does not necessarily reflect intravascular volume [29]. Some have advocated CVP while others rely on PAC to optimize volume status.…”

Section: Volume Statusmentioning

confidence: 99%

The Critical Care Management of Aneurysmal Subarachnoid Hemorrhage

Patel¹,

Samuels²

2012

Aneurysm

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Fluid Balance and Blood Volume Measurement after Aneurysmal Subarachnoid Hemorrhage

Abstract: Calculations of fluid balance do not provide adequate information on actual CBV after SAH, as measured by PDD. This raises doubt whether fluid management guided by fluid balances is effective in maintaining normovolemia.

Cited by 46 publications

References 32 publications

Brain Natriuretic Peptide Concentrations After Aneurysmal Subarachnoid Hemorrhage: Relationship with Hypovolemia and Hyponatremia

Brain Natriuretic Peptide Concentrations After Aneurysmal Subarachnoid Hemorrhage: Relationship with Hypovolemia and Hyponatremia

Blood Volume Measurement to Guide Fluid Therapy After Aneurysmal Subarachnoid Hemorrhage

The Critical Care Management of Aneurysmal Subarachnoid Hemorrhage

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