Heart Rate Variability Predicts Neurogenic Pulmonary Edema in Patients with Subarachnoid Hemorrhage

Chen, Wei-Lung; Chang, Su-Hen; Chen, Jiann-Hwa; Tai, Henry Chih-Hung; Chan, Chih‐Chieh; Wang, Yung-Cheng

doi:10.1007/s12028-015-0237-3

Cited by 22 publications

(20 citation statements)

References 30 publications

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“…A few very interesting randomized trials are currently investigating neurocritical care measures beyond neurosurgery in or including SAH: EARLYDRAIN on early lumbar drainage combined with EVD [9], SETPOINT2 on early tracheostomy [10], NEWTON on slow-release nimodipine via EVD [11], ULTRA on early tranexamic acid [12], and HIMALAIA on induced hypertension [13]. However, there are so many other NCCU aspects to be addressed prospectively: level of sedation, modes of ventilation [14,15], cardiopulmonary stability [16,17], monitoring-based circulatory strategies [18], temperature control [19][20][21], delirium management, the nursing factor and mobilization, policies of do-not-resuscitate orders and withdrawal of care [22,23], and many other day-to-day care decisions that may substantially impact outcome. Particularly, the poor-grade SAH patient, prone to so many cerebral and systemic complications, may benefit from aggressive surveillance, superb nursing care, and close clinical monitoring.…”

mentioning

confidence: 99%

What Do We Mean by Poor-Grade Aneurysmal Subarachnoid Hemorrhage and What Can We Do?

Bösel

2016

Neurocrit Care

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mentioning

confidence: 99%

What Do We Mean by Poor-Grade Aneurysmal Subarachnoid Hemorrhage and What Can We Do?

Bösel

2016

Neurocrit Care

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“…NPE secondary to neurocritical injuries has an estimated incidence ranging between 2% and 50%, and it occurs more often in patients with severe TBI than in those with SAH. [ 1 , 48 ] Based on the mechanism of NPE related to sympathetic nervous activity, Chen et al [ 49 ] examined heart function in 204 patients with SAH and found that heart rate variability can predict the occurrence of NPE.…”

Section: Pulmonary Complications In Nccmentioning

confidence: 99%

Pulmonary complications and respiratory management in neurocritical care: a narrative review

Wen

Chen

Chang

et al. 2022

Chinese Medical Journal

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Neurocritical care (NCC) is not only generally guided by principles of general intensive care, but also directed by specific goals and methods. This review summarizes the common pulmonary diseases and pathophysiology affecting NCC patients and the progress made in strategies of respiratory support in NCC. This review highlights the possible interactions and pathways that have been revealed between neurological injuries and respiratory diseases, including the catecholamine pathway, systemic inflammatory reactions, adrenergic hypersensitivity, and dopaminergic signaling. Pulmonary complications of neurocritical patients include pneumonia, neurological pulmonary edema, and respiratory distress. Specific aspects of respiratory management include prioritizing the protection of the brain, and the goal of respiratory management is to avoid inappropriate blood gas composition levels and intracranial hypertension. Compared with the traditional mode of protective mechanical ventilation with low tidal volume (Vt), high positive end-expiratory pressure (PEEP), and recruitment maneuvers, low PEEP might yield a potential benefit in closing and protecting the lung tissue. Multimodal neuromonitoring can ensure the safety of respiratory maneuvers in clinical and scientific practice. Future studies are required to develop guidelines for respiratory management in NCC.

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“…[4,[11][12][13] Penelitian yang dilakukan oleh Chen et al 2015 di Taiwan menunjukan bradikardia pada pasien SAH akan memberi prognosis buruk NPE. [14] Dari 20 pasien SAH dan NPE di taiwan hanya 1 pasien saja yang bisa melanjutkan kehidupan. [13] Huang et al pada tahun 2016 melakukan penelitian yang mencari hubungan gambaran abnormalitas dalam memprediksi insidensi NPE, dalam penelitian tersebut terdapat hubungan antara abnormalitas gambaran EKG pada pasien dengan NPE.…”

Section: Artikel Tinjauan Pustakaunclassified

Neurogenic Pulmonary Edema: Komplikasi Yang Mengancam Jiwa Akibat Kerusakan Berat Sistem Saraf Pusat

Gumantara¹

2020

ESSENTIAL

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ABSTRACT Neurogenic Pulmonary Edema (NPE) is one of the complications due to severe damage of the central nervous system (CNS). The incidence is about 2-8% in the world and still rarely reported. Neurogenic pulmonary edema (NPE) commonly found in cases of intracranial hemorrhage such as SDH, SAH, and ICH, in conditions of uncontrolled epilepsy and recurrent seizures, and in some cases of spinal cord trauma. The pathogenesis of Neurogenic Pulmonary Edema (NPE) cannot be fully understood, but there are 2 theories of the occurrence of Neurogenic Pulmonary Edema (NPE), the first namely as theory of hemodynamic changes and the second is NPE trigger zones involving the central control of the brain's autonomic and cardiovascular system. Neurogenic Pulmonary Edema (NPE) has an acute and chronic onset, which is characterized by ARDS-like symptoms such as dyspnea, tachypnea, tachycardia, reddish sputum, crackles in auscultation, and radiological features in the form of diffuse alveolar infiltrat bilateral. Early recognition of signs and symptoms of Neurogenic Pulmonary Edema (NPE) can improve the patient's outcome. Initial treatment of this condition uses two management principles, first overcoming the underlying disease condition and second is supportive therapy, such as mechanical ventilator, ECMO, and transpulmonary thermodilution, the use of diuretics, and controlling fluid therapy.

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Heart Rate Variability Predicts Neurogenic Pulmonary Edema in Patients with Subarachnoid Hemorrhage

Abstract: Loss of cardiac variability and depressed sympathovagal modulation, represented by TP and LF %, may predict the development of NPE in the early stage in patients with SAH.

Cited by 22 publications

References 30 publications

What Do We Mean by Poor-Grade Aneurysmal Subarachnoid Hemorrhage and What Can We Do?

What Do We Mean by Poor-Grade Aneurysmal Subarachnoid Hemorrhage and What Can We Do?

Pulmonary complications and respiratory management in neurocritical care: a narrative review

Neurogenic Pulmonary Edema: Komplikasi Yang Mengancam Jiwa Akibat Kerusakan Berat Sistem Saraf Pusat

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