Effect of Inhalatory Sedation in Subarachnoid Hemorrhage

A.O.U. Città della Salute e della Scienza11 enrolled

Overview

The aim of this study is to evaluate the effect of inhalational sedation on cerebral perfusion in patients with SAH. It will evaluate whether the administration of isofluorane, by inducing direct vasodilation in the cerebral parenchyma, can improve the cerebral perfusion rates. Perfusional CT will be used to study the variation of cerebral blood flow to rule out the vasodilatory effect on territories with different cerebrovascular reactivity aggravating the phenomena of distrectual hypoperfusion (theft theory).

Study Type

INTERVENTIONAL

Allocation

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Subarachnoid Hemorrhage Aneurysmal Subarachnoid Hemorrhage

Interventions

Isoflurane Inhal SolnDRUG

Administration of isofluorane in patients with severe SAH

Eligibility

Sex: ALLMin age: 18 YearsMax age: 64 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 years old * Diagnosis of non-traumatic SAH * Neurological and/or systemic presentation that requires support of vital functions and sedation. This occurs for a WFNS score (World Federation of Neurosurgical Societies) ≥ 3. * Possibility of ICP monitoring through EVD which is necessary in case of acute hydrocephalous. In case of the neurosurgeon do not indicate the positioning of the EVD, an intraparenchymal catheter will be positioned for the ICP monitoring. * Patients with vasospasm (area of cerebral blood flow under 30% of the best value detected in the brain of the patients at the first CT scan). This exam will be performed at 2° - 3° day post event. * Acceptance of informed consent. Exclusion Criteria: * Documented outcomes of cerebrovascular disease * Patients with acute heart failure related to ESA * State of pregnancy * Patients with CLCR \< 30 mL/min

Locations (1)

AOU Città della Salute e della Scienza - Presidio CTO

Torino, Italy

Outcomes

Primary Outcomes

Cerebral blood flow recondtion

The percentage of subjects who had a flow recondition at the second CT at least 50% of the best value detected in the first perfusion CT scan

Time frame: 20 minutes

Secondary Outcomes

Changes in intracranial pressure during isoflurane delivery

We evaluate if isofluorane create an increase in ICP trough continuous monitoring.

Time frame: 20 minutes

Changes in blood pressure during isoflurane delivery

By its vasodilatatore effect, we monitored punctually if mean arterial blood pressure will increase during isofluorane delivery

Time frame: 20 minutes

Data from ClinicalTrials.gov

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