KSCCM
Search
- Page Path
- HOME > Search
Original Article
- Neurosurgery
- The RAP Index during Intracranial Pressure Monitoring as a Clinical Guiding for Surgically Treated Aneurysmal Subarachnoid Hemorrhage: Consecutive Series of Single Surgeon
- Sung-Chul Jin, Byung Sam Choi, Jung-Soo Kim
- Acute Crit Care. 2019;34(1):71-78. Published online February 28, 2019
- DOI: https://doi.org/10.4266/acc.2019.00437
- 6,506 View
- 134 Download
- 3 Web of Science
- 3 Crossref
-
Abstract
PDF - Background
It is well known that assessing the RAP index along with intracranial pressure (ICP) monitoring in traumatic brain injury patients is helpful. We will discuss the usefulness of this assessment tool as a clinical guide for surgically treated poor grade aneurysmal subarachnoid hemorrhage (SAH).
Methods
This retrospective study included 35 patients with aneurysmal SAH who presented with World Federation of Neurosurgical Societies (WFNS) grade V SAH and received surgical treatment from January 2013 to December 2018. Emergency surgical clipping, hematoma removal, extraventricular drainage, and if needed, wide decompressive craniectomy were combined as the proper surgical treatments. Outcomes were assessed based on in-hospital survival and the Glasgow outcome scale score at 14-day follow-up. We compared the mortality rate of two groups of seven patients: ICP monitoring only (n=5) and ICP monitoring combined with the RAP index (n=2).
Results
The in-hospital 14-day mortality rate by brain lesion was 48.5% (n=17). Seven patients had real-time ICP monitoring. Before 2018, three of five patients with poor WFNS grade who received real-time ICP monitoring only died. There were no deaths in the group of two patients receiving real-time ICP monitoring and the RAP index.
Conclusions
Our data indicate that combining the RAP index and ICP monitoring can be used as markers for critical intracranial physiological parameters in poor grade WFNS patients. -
Citations
Citations to this article as recorded by
- Multimodal Neurologic Monitoring in Children With Acute Brain Injury
Jennifer C. Laws, Lori C. Jordan, Lindsay M. Pagano, John C. Wellons, Michael S. Wolf
Pediatric Neurology.2022; 129: 62. CrossRef - Intracranial pressure: current perspectives on physiology and monitoring
Gregory W. J. Hawryluk, Giuseppe Citerio, Peter Hutchinson, Angelos Kolias, Geert Meyfroidt, Chiara Robba, Nino Stocchetti, Randall Chesnut
Intensive Care Medicine.2022; 48(10): 1471. CrossRef - The application value of CT radiomics features in predicting pressure amplitude correlation index in patients with severe traumatic brain injury
Jiaqi Liu, Yingchi Shan, Guoyi Gao
Frontiers in Neurology.2022;[Epub] CrossRef
- Multimodal Neurologic Monitoring in Children With Acute Brain Injury
Case Report
- Cardiology/Pediatric
- Acute Myocardial Infarction during the Subacute Phase of Refractory and Incomplete Kawasaki Disease in a Five-year-old Boy
- Chul Jin, Yeo Hyang Kim, Hyung Seop Kim
- Korean J Crit Care Med. 2014;29(1):23-26. Published online February 28, 2014
- DOI: https://doi.org/10.4266/kjccm.2014.29.1.23
- 6,011 View
- 79 Download
-
Abstract
PDF
- Kawasaki disease (KD) is an acute, systemic vasculitis of childhood. The early mortality of KD results from coronary complications, mainly aneurysmal thrombosis with myocardial infarction, and the subacute phase of KD has the highest risk of mortality. Although there have been reports of ischemic heart disease as late cardiologic sequelae of KD in young adults, acute myocardial infarction caused by coronary complications in the subacute phase of KD is rare. We experienced one pediatric patient who developed coronary artery aneurysm and acute myocardiac infarction (AMI) during the subacute phase of incomplete and intravenous immunoglobulin (IVIG)-nonresponsive KD. The patient was given a good prognosis due to close monitoring and early recognition of AMI. Physicians should carefully monitor KD patients who do not respond to initial IVIG therapy and who show progressive coronary artery dilatation. If such a patient complaints of chest pain and the ECG shows hyperacute T waves, the physician should suspect development of AMI.
First
Prev
