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Investigating the relationship between high-dose norepinephrine administration and the incidence of delayed cerebral infarction in patients with aneurysmal subarachnoid hemorrhage: A single-center retrospective evaluation

Author

Listed:
  • Andrea Cattaneo
  • Christoph Wipplinger
  • Caroline Geske
  • Florian Semmler
  • Tamara M Wipplinger
  • Christoph J Griessenauer
  • Judith Weiland
  • Alexandra Beez
  • Ralf-Ingo Ernestus
  • Thomas Westermaier
  • Ekkehard Kunze
  • Christian Stetter

Abstract

Background: One of the longest-standing treatments to prevent delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH) remains raising the blood pressure to a certain level of mean arterial pressure. This may require high doses of norepinephrine, which has been associated with severe end organ damage. With this study, we aimed to investigate the effects of norepinephrine on the incidence of DCI in a clinical setting. Methods: We conducted a retrospective evaluation of patients with aSAH admitted to our institution between November 2018 and March 2021. Potential risk factors for DCI were analyzed and significant predictors were assessed by means of a logistic regression analysis to account for potential confounders. Results: In this study, 104 patients were included. Hereof, 39 (38%) showed radiologic signs of DCI between day three and 14 post-intervention. These patients had more frequent vasospasms (n = 37 vs. 30, p = 0.022), a higher Hunt & Hess score (3 ± 2 vs. 2 ± 1, p = 0.004), a lower initial Glasgow Coma Scale score (9 ± 5 vs. 12 ± 4, p = 0.003) and received a higher median norepinephrine dose (20,356μg vs. 6,508μg, p

Suggested Citation

  • Andrea Cattaneo & Christoph Wipplinger & Caroline Geske & Florian Semmler & Tamara M Wipplinger & Christoph J Griessenauer & Judith Weiland & Alexandra Beez & Ralf-Ingo Ernestus & Thomas Westermaier &, 2023. "Investigating the relationship between high-dose norepinephrine administration and the incidence of delayed cerebral infarction in patients with aneurysmal subarachnoid hemorrhage: A single-center ret," PLOS ONE, Public Library of Science, vol. 18(3), pages 1-15, March.
    • Handle: RePEc:plo:pone00:0283180
    DOI: 10.1371/journal.pone.0283180
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