Kolar M, Nohejlova K, Mares J, Pachl J
Department of Anesthesiology and Critical Care Medicine, Third Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Normal, Pathological and Clinical Physiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Physiol Res. 2016 Dec 22;65(Suppl 5):S591-S599. doi: 10.33549/physiolres.933536.
Causes of early hypoperfusion after subarachnoid hemorrhage (SAH) include intracranial hypertension as well as vasoconstriction. The aim of the study was to assess the effect of intracerebroventricular (ICV) administration of sodium nitroprusside (SNP) on early hypoperfusion after SAH. Male Wistar rats (220-240 g) were used, SAH group received 250 microl of fresh autologous arterial blood into the prechiasmatic cistern; sham-operated animals received 250 microl of isotonic solution. Therapeutic intervention: ICV administration of 10 microg SNP; 5 microl 5 % glucose (SNP vehicle) and untreated control. Brain perfusion and invasive blood pressure were monitored for 30 min during and after induction of SAH. Despite SNP caused increase of perfusion in sham-operated animals, no response was observed in half of SAH animals. The other half developed hypotension accompanied by brain hypoperfusion. There was no difference between brain perfusion in SNP-treated, glucose-treated and untreated SAH animals during the monitored period. We did not observe expected beneficial effect of ICV administration of SNP after SAH. Moreover, half of the SNP-treated animals developed serious hypotension which led to brain hypoperfusion. This is the important finding showing that this is not the option for early management in patient after SAH.
蛛网膜下腔出血（SAH）后早期灌注不足的原因包括颅内高压以及血管收缩。本研究的目的是评估脑室内（ICV）注射硝普钠（SNP）对SAH后早期灌注不足的影响。使用雄性Wistar大鼠（220 - 240克），SAH组将250微升新鲜自体动脉血注入视交叉前池；假手术动物注入250微升等渗溶液。治疗干预：ICV注射10微克SNP；5微升5%葡萄糖（SNP溶媒）以及未治疗的对照组。在SAH诱导期间及之后监测脑灌注和有创血压30分钟。尽管SNP使假手术动物的灌注增加，但在一半的SAH动物中未观察到反应。另一半出现低血压并伴有脑灌注不足。在监测期间，SNP治疗组、葡萄糖治疗组和未治疗的SAH动物的脑灌注之间没有差异。我们未观察到SAH后ICV注射SNP的预期有益效果。此外，一半接受SNP治疗的动物出现严重低血压，导致脑灌注不足。这一重要发现表明，这不是SAH患者早期治疗的选择。
