Sustained Low-Efficiency Dialysis is Associated with Worsening Cerebral Edema and Outcomes in Intracerebral Hemorrhage

Shirazian, Alireza; Peralta-Cuervo, Andres F.; Aguilera-Pena, María Paula; Cannizzaro, Louis A.; Tran, Vi; Nguyen, Doan; Iwuchukwu, Ifeanyi

doi:10.1007/s12028-020-01155-3

Cited by 6 publications

(17 citation statements)

References 46 publications

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“…17,24 Seven studies (n = 4473 patients) assessed the influence of PHO growth on poor functional outcome. 21,23,25,29,36,41,42 Six out of the seven studies measured aPHO increase while one study assessed increase in OED. 23 There was large variation in the interval between symptom onset, baseline PHO measurement and the timing of the assessment of PHO growth.…”

Section: Resultsmentioning

confidence: 99%

“…37 Combining these two studies 28,37 with the studies included the primary analysis, 22,24,30,38 we found a pooled OR of 1.02 (95% CI 1.00-1.04, p = 0.1, I 2 = 76%) for the association between PHO and mRS 3 and 6 at any time of follow-up. Seven studies (n = 2793 patients) 25,27,29,31,36,39,42 reported on the influence of PHO and mRS score 4-6 at 3 months. Three of these studies (n = 1398) 25,36,42 assessed PHO growth as their primary analysis, the other four (n = 1395) 27,29,31,39 measured aPHO.…”

Section: Resultsmentioning

confidence: 99%

“…After full text screening of 309 studies, we extracted 54 studies of which we included a total of 27 studies in our analyses with a total of 9534 patients ( Figure 1 ; Supplemental Table 1 ). 16 – 42 Using the NOS scale, 11 studies were classified as of fair quality and 16 studies were deemed of high quality. Median risk of bias score was seven (IQR 6–8; Supplemental Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

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The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

Cliteur

Sondag

Cunningham

et al. 2023

European Stroke Journal

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Purpose: Perihaematomal oedema (PHO) formation has gained increasing interest as a therapeutic target after spontaneous intracerebral haemorrhage (ICH). Whether PHO contributes to poor outcome is unclear. We aimed to determine the association between PHO and outcome in patients with spontaneous ICH. Method: We searched five databases up to 17 November 2021 for studies of ⩾10 adults with ICH reporting the presence of PHO and outcome. We assessed risk of bias, extracted aggregate data and used random effects meta-analysis to pool studies that reported odds ratios (OR) with 95% confidence intervals (CI). Primary outcome was poor functional outcome defined as modified Rankin Scale score of 3–6 at 3 months. Additionally, we assessed PHO growth and poor outcome at any time of follow-up. We prospectively registered the protocol in PROSPERO (CRD42020157088). Findings: We identified 12,968 articles, of which we included 27 studies ( n = 9534). Eighteen studies reported an association between larger PHO volume and poor outcome, six a neutral result and three an inverse relationship. Larger absolute PHO volume was associated with poor functional outcome at 3 months (OR per mL increase of absolute PHO 1.03, 95% CI 1.00–1.06, I2 44%, four studies). Additionally, PHO growth was associated with poor outcome (OR 1.04, 95% CI 1.02–1.06, I2 0%, seven studies). Discussion: In patients with spontaneous ICH, larger PHO volume is associated with poor functional outcome at 3 months. These findings support the development and investigation of new therapeutic interventions targeting PHO formation to evaluate if reduction of PHO improves outcome after ICH.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

Cliteur

Sondag

Cunningham

et al. 2023

European Stroke Journal

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“…Furthermore, two clinical studies revealed that the high absolute volume of PHE within 12 h or on days 1-12 after symptom onset was correlated with a negative functional effect, representing a possible treatment target [ 20 , 175 ]. Additional studies in specific patient groups (e.g., prehospital use of nonoral anticoagulants or patients with chronic kidney disease) also revealed that an absolute increase in PHE within 12 or 48 h after ictus was an independent predictor of poor outcome after ICH [ 99 , 176 ]. It seems that the variation in time points in the acute or subacute phase does not impact the predictive value of absolute PHE on functional outcome after ICH.…”

Section: Phe and Functional Outcomesmentioning

confidence: 99%

“…Abbreviations: CSF: cerebrospinal fluid; ISF: interstitial fluid; CLNs: cervical lymph nodes; TBI: traumatic brain injury; ICP: intracranial pressure; AQP4: aquaporin 4; ICH: intracerebral hemorrhage. 13 Oxidative Medicine and Cellular Longevity [99,176]. It seems that the variation in time points in the acute or subacute phase does not impact the predictive value of absolute PHE on functional outcome after ICH.…”

Section: Clinical Studiesmentioning

confidence: 99%

Molecular, Pathological, Clinical, and Therapeutic Aspects of Perihematomal Edema in Different Stages of Intracerebral Hemorrhage

Jiang

Guo

Zhang

et al. 2022

Oxidative Medicine and Cellular Longevity

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Acute intracerebral hemorrhage (ICH) is a devastating type of stroke worldwide. Neuronal destruction involved in the brain damage process caused by ICH includes a primary injury formed by the mass effect of the hematoma and a secondary injury induced by the degradation products of a blood clot. Additionally, factors in the coagulation cascade and complement activation process also contribute to secondary brain injury by promoting the disruption of the blood-brain barrier and neuronal cell degeneration by enhancing the inflammatory response, oxidative stress, etc. Although treatment options for direct damage are limited, various strategies have been proposed to treat secondary injury post-ICH. Perihematomal edema (PHE) is a potential surrogate marker for secondary injury and may contribute to poor outcomes after ICH. Therefore, it is essential to investigate the underlying pathological mechanism, evolution, and potential therapeutic strategies to treat PHE. Here, we review the pathophysiology and imaging characteristics of PHE at different stages after acute ICH. As illustrated in preclinical and clinical studies, we discussed the merits and limitations of varying PHE quantification protocols, including absolute PHE volume, relative PHE volume, and extension distance calculated with images and other techniques. Importantly, this review summarizes the factors that affect PHE by focusing on traditional variables, the cerebral venous drainage system, and the brain lymphatic drainage system. Finally, to facilitate translational research, we analyze why the relationship between PHE and the functional outcome of ICH is currently controversial. We also emphasize promising therapeutic approaches that modulate multiple targets to alleviate PHE and promote neurologic recovery after acute ICH.

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Clinical efficacy and safety of neuroendoscopic surgery for severe thalamic hemorrhage with ventricle encroachment

et al. 2022

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Sustained Low-Efficiency Dialysis is Associated with Worsening Cerebral Edema and Outcomes in Intracerebral Hemorrhage

Cited by 6 publications

References 46 publications

The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

Molecular, Pathological, Clinical, and Therapeutic Aspects of Perihematomal Edema in Different Stages of Intracerebral Hemorrhage

Clinical efficacy and safety of neuroendoscopic surgery for severe thalamic hemorrhage with ventricle encroachment

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