Association Between Blood Transfusion And Symptomatic Vasospasm After Rupture Of Cerebral Aneurysm

Object Nitric oxide (NO) metabolism may influence vasospasm after aneurismal rupture. It has been demonstrated in recent studies that in this process the NO is not only produced by the wall of blood vessels but also stored, transferred and released by the circular red blood cell (RBD) to dilate the blood vessels Then local balance of oxygen supply is regulated. Whereas, transfused erythrocytes may lack stored NO and several converging lines of evidence also indicate that blood transfusion may exacerbate poor outcomes in some critically ill patients. So ,in this study we will discuss the association of blood transfusion and other related factors between symptomatic vasospasm after rupture of cerebral aneurysm , and the influence of the blood transfusion to the outcome. Method We retrospectively reviewed a observational database.including hospital records, computerized tomography (CT) scans, digital substraction angiography (DSA) and transcranial Dopplers(TCD), in which the diagnosis and management methods used in 224 chosen patients were controlled and described according to routine of our department. Wecollected datum, used statistical analysis and got meaningful results and drew conclusions after adjustment for Hunt and Hess grade, SAH grade on CT scans, delay between rupture and surgery, intraoperative aneurysm rupture, hemoglobin level and smoking history. All datum are achieved by hospital records, phone call and correspondence.Results and conclusions Our study has three main conclusions. (1) Symptomatic vasospasm after aneurismal subarachnoid hemorrhage (SAH) is associated with RBC transfusion. Patients receiving blood transfusion have higher risk. (2) The level of hemoglobin is associated with symptomatic vasospasm after aneurismal SAH. Lower hemoglobin level infers higher risk. (3) Blood transfusion is an independent factor influencing outcome of aneurismal SAH and is associated with worse outcome. There are other meaningful results in our study: (1) Hunt and Hess grade, SAH grade on CT scans, delay between rupture and surgery, intraoperative aneurysm rupture and smoking history are risk factors for incidence of symptomatic vasospasm after aneurismal SAH and poor outcome. (2) Local incidence of cerebral aneurysm according to sex, age and position, et.ct. (3) The near and distant effects of the managements in our depatment.