ササキ　トシユキ   Sasaki Toshiyuki   佐々木　寿之    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Bedside monitoring of circulating blood volume after subarachnoid hemorrhage.
掲載誌名	正式名：Stroke 略　 称：Stroke ISSNコード：1524-4628(Electronic)0039-2499(Linking)
巻・号・頁	34(4),pp.956-60
著者・共著者	Kasuya Hidetoshi, Onda Hideaki, Yoneyama Taku, Sasaki Toshiyuki, Hori Tomokatsu
発行年月	2003/04
概要	BACKGROUND AND PURPOSE:Maintenance of an adequate intravascular volume is important in the management of patients with subarachnoid hemorrhage (SAH). The purpose of this study was to investigate the circulating blood volume (CBV) after SAH with the use of indocyanine green pulse spectrophotometry.METHODS:CBV and plasma hormones related to stress and fluid regulation were measured 4 times: day 2 to 3, day 4 to 5, day 7 to 8, and day 14 in 50 consecutive patients with SAH surgically treated within 48 hours.RESULTS:The mean value of CBV was 64 mL/kg on day 2 to 3, which gradually increased to 69 mL/kg on day 4 to 5, 71 mL/kg on day 7 to 8, and 70 mL/kg on day 14 (P=0.005) (control, 72 mL/kg). The clinical grades and plasma corticotropin levels were higher in patients withRESULTS:<RESULTS:60 mL/kg of CBV on day 2 to 3 (PRESULTS:<RESULTS:0.05 for both). There were no significant differences in other physiological and laboratory parameters such as time for surgery, estimated blood loss, levels of plasma noradrenaline, brain natriuretic peptide, serum sodium, and hematocrit. When CBV was decreasedRESULTS:>RESULTS:10% of the former level, there were decreases in hematocrit (PRESULTS:<RESULTS:0.05), serum sodium (PRESULTS:<RESULTS:0.01), and serum albumin (PRESULTS:<RESULTS:0.05) and an increase in urinary sodium (PRESULTS:<RESULTS:0.05).CONCLUSIONS:A significant reduction of CBV, especially in patients with poor clinical grades, was noted after SAH and early surgery, which could not be detected by routine examinations. Anemia, central salt wasting, and hypoalbuminemia may be related to aCONCLUSIONS:decrease in CBV from the former level. Indocyanine green pulse spectrophotometry may be a powerful tool for the management of patients with SAH.
DOI	10.1161/01.STR.0000064321.10700.63
文献番号	12649506