Monitoring Of The Effect Of Cerebral Autoregulation On Delayed Cerebral Ischemia In Patients With Aneurysmal Subarachnoid Hemorrhage

ObjectiveTo detect cerebral autoregulation(CA)in patients with aneurysmal subarachnoid hemorrhage(aSAH)by near-infrared spectroscopy and to assess its association with delayed cerebral ischemia(DCI).MethodsFrom January to August 2017,101 patients(average age 53.37 ±10.33 years)were enrolled in this study,included 33 male and 68 female with ruptured or unruptured cerebral aneurysms.Near-infrared spectroscopy was used to monitor CA,and associated factors were evaluated.Monitoring of CA was carried out at 5 time-points(preoperative day 1 and postoperative days 1,2,3,and 7).81 Patients with aSAH were sorted into 2 groups according to whether DCI occurred(DCI group and non-DCI group),20 patients with unruptured aneurysm as a control group.The relationship between CA and DCI in patients with aSAH was analyzed.ResultsAmong 81 patients,CA trended toward being impaired in patients with aSAH with a poorer grade.Comparatively,impaired CA occurred in 2of 20(10%)in control group.DCI occurred in 39 of 51(48.15%)patients with impaired CA.DCI occurred in 6 of 30(7.4%)patients with intact CA.ConclusionsImpaired CA monitored by near-infrared spectroscopy was shown in patients with aSAH before and after surgical intervention.Older age,smoking,hypertension,and especially impaired CA are independent risk factors for patients with DCI.