RELATION BETWEEN MEAN BLOOD PRESSURE (MAP) AND LINDEGAARD RATIO IN PATIENTS UNDERGOING SURGERY FOR A NON-RUPTURE BRAIN ANEURYSM. THE ROLE OF USING CATECHOLAMINES

Monov D., Tsonev Hr

Abstract


Summary:

The aim of the study is to analyze and establish the relation between mean arterial pressure (MAP) and cerebral blood supply, respectively, cerebral vasospasm, in patients operated for non-ruptured cerebral aneurysms in the early postoperative period by measuring the Lindegaard ratio.

Materials and methods:

The study included 48 patients operated on non-ruptured brain aneurysms for the period from May 2018. until June 2019. The patients were divided into two groups, depending on the MAP values and the use of catecholamines in the early postoperative period, with the Lindegaard ratio measured by transcranial Doppler ultrasound.

Results:

Depending on the values of MP, patients are divided into two groups: MBP 70-90 mm / Hg and 90 mm / Hg. Better brain perfusion was reported in the 90 mm / Hg group with 23.23%, respectively, a lower Lindegaard ratio, despite better results in comparing the two groups of patients, the improvement in cerebral blood flow was not statistically significant, p value  < 0.5. Depending on the use of catecholamines in the early postoperative period, we divide patients into two groups: with and without catecholamine . In the catecholamine - treated group, brain perfusion was reported to be better by 32.14%, despite these results, comparing the two groups of patients,
improvement in cerebral blood supply was not statistically significant with  p value  <0.5.


Conclusion:


It is theoretically permissible to assume that the use of catecholamines and maintaining a MBP above 90mmHg leads to better brain perfusion and prevention of cerebrovascular vasospasm in patients operated on non-ruptured cerebral aneurysms. Forward is necessary to cover a larger cohort of patients in order to demonstrate statistical significance in the results obtained.



Keywords


MBP, Lindegaard ratio, Transcranial Doppler ultrasound, cerebrovascular vasospasm

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