Hemodynamic challenges in traumatic subarachnoid hemorrhage complicated by cerebral vasospasm
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Department of Critical Care, School of Medicine, University of Thessaly, University Hospital of Larissa, Thessaly, Greece
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Figure
Neuroimaging evolution in our two patients with traumatic subarachnoid hemorrhage.
We have read with great interest the recent review by Varvarousi et al
[1]
on the role of levosimendan in the clinical setting of aneurysmal subarachnoid hemorrhage (SAH). Previous work by us
[2]
and others
[3,4]
proposed depressed cardiac output (CO), mainly attributed to catecholamine-mediated myocardial dysfunction, as a critical determinant of delayed cerebral ischemia (DCI) and poor neurologic outcome. In this respect, rapid hemodynamic augmentation, with either levosimendan
[5]
or other agents
[6]
, has the potential to reverse cerebral ischemia and prevent further brain damage.
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© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
