Persistence of systemic and cerebral perfusion impairment in patients with neurocardiac injury after aneurysmal subarachnoid hemorrhage

Methods Longitudinal prospective analysis of 38 patients with aSAH. Inclusion: age 21-75 years, spontaneous aneurysm rupture, Fisher grade >1 and/or Hunt and Hess grade (HH) >2. Exclusion: traumatic SAH, recent myocardial dysfunction. Daily averages of systemic (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial blood pressure [MAP], heart rate [HR]) and cerebral (cerebral perfusion pressure [CPP]) perfusion parameters were used. Blood pressure was measured with arterial line, or if no arterial line then sphygmomanometer. Intracranial pressure (ICP) was measured using external ventricular drain and was used to calculate CPP (MAP-ICP). Mixed model linear regression was performed to test the difference in perfusion over time. Modeling was performed using the daily average for each perfusion parameter for each of days 0 to 14, and both without and with covariates (age, gender HH grade). The independent variable was daily average cTnI-High.