SAH Clinical Trial
Official title:
Does a PiCCO-controlled Advanced Haemodynamic Monitoring Improve the Outcome After Aneurysmal Subarachnoid Haemorrhage?
The objective of this study is to determine whether a goal-directed therapy can reduce the incidence of delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage.
The aneurysmal subarachnoid haemorrhage (SAH) is a frequent and dangerous worldwide cause for
stroke. A typical complication presents delayed cerebral ischemia as a consequence of
cerebral vasospasms, which occurs in 46% of the cases. The Triple-H-therapy (Hypervolaemia,
Hypertension and Haemodilution) was favoured to prevent ischaemic complications after
vasospasm for a long time. However recently, the focus is mainly on hypertension, and it is
recommended to maintain normovolaemia. The debate how to assure normovolaemia is still on
going, therefore, this study was designed to examine whether a PiCCO-controlled haemodynamic
monitoring and a goal-directed therapy can reduce the incidence of delayed cerebral ischaemia
after SAH.
The present study is a prospective randomized controlled clinical study. Patients older than
18 years with an aneurysmal SAH will be enrolled. They will be divided into two groups: a
control group "C" and a PiCCO group "P". Both groups will be treated according to the current
guidelines. In addition, in group P the volume and catecholamine therapy will be controlled
by means of PiCCO-controlled monitoring and an algorithm.
The primary end point is the number of occurred delayed cerebral ischaemia per patient.
Secondary end points are neurological, pulmonary, cardiovascular, renal, and hepatic
complications as well as electrolyte and serum glucose disturbance, sepsis, and mortality,
length of hospital and intensive care unit stay and the amount of volume and catecholamines
administered.
All participants are to be contacted three months after discharge, and their health status is
to be determined by using the GOS (Glasgow Outcome Scale).
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