https://scholars.lib.ntu.edu.tw/handle/123456789/590481
標題: | Intrathecal lactate predicting hydrocephalus after aneurysmal subarachnoid hemorrhage | 作者: | KUO-CHUAN WANG SUNG-CHUN TANG Lee J.-E. JIANN-SHING JENG DAR-MING LAI Huang S.-J. SUNG-TSANG HSIEH YONG-KWANG TU |
公開日期: | 2015 | 卷: | 199 | 期: | 2 | 起(迄)頁: | 523 | 來源出版物: | Journal of Surgical Research | 摘要: | Background Evidence shows possible benefits from continuous drainage by lumbar drain after aneurysmal subarachnoid hemorrhage (SAH). Under the hypothesis that compartmentalization occurs between the ventricle and subarachnoid space after massive SAH, this study aimed to evaluate the biochemical differences between ventricular and intrathecal cerebrospinal fluid (CSF) and assess the role of CSF lactate in shunt-dependent hydrocephalus (SDHC) after aneurysmal SAH. Materials and methods Patients with modified Fisher grade III/IV aneurysmal SAH who underwent early obliteration were evaluated. Intrathecal and intraventricular CSF were obtained on day 7 post-SAH to measure their biochemical composition in terms of total protein, glucose, ferritin, and lactate. The associations of SDHC with the clinical parameters and CSF data were analyzed. Results There were 28 patients (mean age, 55.4 y; males, 46.6%), including 18 (64.3%) with SDHC. Intrathecal CSF had significantly higher levels of total protein, ferritin, hemoglobin, and lactate but lower glucose level than intraventricular CSF (all P < 0.0001). By multivariate analysis of clinical and CSF parameters, elevated intrathecal CSF lactate (P = 0.036) and the presence of intraventricular hemorrhage (P = 0.05) were independent factors associated with SDHC. Moreover, intrathecal lactate >5.5 μM effectively predicted the occurrence of SDHC (odds ratio: 32, 95% confidence interval: 3.8-270.8; P = 0.0015). Conclusions By compartmentalization of the subarachnoid space after SAH, intrathecal lactate level is a useful predictive parameter for long-term SDHC in patients with aneurysmal SAH patients. © 2015 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84947870189&doi=10.1016%2fj.jss.2014.09.022&partnerID=40&md5=c17f140eeacbdbb7f4502b2600135fac https://scholars.lib.ntu.edu.tw/handle/123456789/590481 |
ISSN: | 224804 | DOI: | 10.1016/j.jss.2014.09.022 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。