Stewart-Amidei C
Department of Neurological Surgery, Loyola University Medical Center, Maywood, Ill.
Heart Lung. 1989 Nov;18(6):590-8.
Subarachnoid hemorrhage (SAH) refers to the sudden accumulation of blood in the subarachnoid space or in the ventricular system. The hemorrhage may occur with cerebral anomalies, tumors, or trauma. The presence of SAH has been associated with decreases in cerebral blood flow (CBF), which may be attributed in part to increased blood viscosity and hematocrit. Hypervolemic hemodilution is a new therapy that is used in the patient with decreased CBF. The therapy is designed to decrease the hematocrit and the viscosity of blood, subsequently increasing CBF. The patient must have a documented SAH and have a baseline neurologic status compatible with aggressive intervention to qualify for the therapy. The infusion technique is begun with 5% albumin and continued for 3 to 7 days. The dosage is gradually tapered before discontinuation. Effectiveness of the therapy is measured through improvement in neurologic function and regional CBF measurements. The critical care nurse plays a vital role in administering and monitoring the therapy and in educating the family about the disease process and interventions.
蛛网膜下腔出血（SAH）是指血液在蛛网膜下腔或脑室系统中突然积聚。出血可能与脑畸形、肿瘤或创伤有关。SAH的出现与脑血流量（CBF）降低有关，这可能部分归因于血液粘度和血细胞比容的增加。高血容量血液稀释是一种用于CBF降低患者的新疗法。该疗法旨在降低血细胞比容和血液粘度，随后增加CBF。患者必须有记录在案的SAH，并且基线神经状态与积极干预相适应，才有资格接受该疗法。输注技术从5%白蛋白开始，持续3至7天。在停药前逐渐减少剂量。通过神经功能的改善和局部CBF测量来衡量该疗法的有效性。重症监护护士在实施和监测该疗法以及向家属介绍疾病过程和干预措施方面发挥着至关重要的作用。
