[Cardiorespiratory problems in the use of calcium antagonists for vasospasm prophylaxis in subarachnoid hemorrhage].

Since studies by Allen et al. [1] calcium antagonists have been commonly used for prevention of cerebral vasospasm in patients suffering from acute subarachnoid hemorrhage (SAH). Vasodilatation-induced hypotension, increase of cardiac output and intrapulmonary shunting (Qs/Qt) are wellknown cardiovascular effects. These problems are discussed in light of previous reports and present case study of a 34-year-old woman treated with the calcium antagonist nimodipine after SAH. Reproducible results from invasive haemodynamic monitoring (Swan-Ganz-thermodilution catheter) indicated correlation between nimodipine application and increased intrapulmonary shunting. This effect can be hazardous for SAH patients because preexisting cerebral ischemic hypoxia makes them particularly susceptible to additional decrease in oxygen supply.