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Pulmonary Edema and Cardiac Dysfunction Following Subarachnoid Hemorrhage

Published online by Cambridge University Press:  02 December 2014

Nancy McLaughlin ,
Michel W. Bojanowski ,
François Girard  and
André Denault
Nancy McLaughlin
Affiliation:
Department of Neurosurgery, Centre Hospitalier de l'Université de Montréal (CHUM) - Hôpital Notre-Dame, Montreal, Qc, Canada
Michel W. Bojanowski
Affiliation:
Department of Neurosurgery, Centre Hospitalier de l'Université de Montréal (CHUM) - Hôpital Notre-Dame, Montreal, Qc, Canada
François Girard
Affiliation:
Department of Anesthesiology, CHUM - Hôpital Notre-Dame, Montreal, Qc, Canada
André Denault
Affiliation:
Department of Anesthesiology, Montreal Heart Institute, and the Department of Medecine - Critical Care Division, CHUM - Hôpital Notre-Dame, Montreal, Qc, Canada
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Abstract:

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Background:

Pulmonary edema (PE) can occur in the early or late period following subarachnoid hemorrhage (SAH). The incidence of each type of PE is unknown and the association with ventricular dysfunction, both systolic and diastolic, has not been described.

Methods:

Retrospective chart review of 178 consecutive patients with SAH surgically treated over a three-year period. Patients with pulmonary edema diagnosed by a radiologist were included. Early onset SAH was defined as occurring within 12 hours. Cardiac function at the time of the PE was analyzed using hemodynamic and echocardiographic criteria of systolic and diastolic dysfunction. Pulmonary edema was observed in 42 patients (28.8%) and was more often delayed (89.4%). Evidence of cardiac involvement during PE varied between 40 to 100%.

Results and conclusions:

Pulmonary edema occurs in 28.8% of patients after SAH, and is most commonly delayed. Cardiac dysfunction, both systolic and diastolic, is commonly observed during SAH and could contribute to the genesis of PE after SAH.

Résumé:

RÉSUMÉ:Introduction:

L’oedème pulmonaire (OP) peut survenir précocement ou tardivement après une hémorragie sousarachnoïdienne (HSA). L’incidence de chaque type d’OP est inconnue et l’association à une dysfunction ventriculaire tant systolique que diastolique n’a jamais été décrite.

Méthodes:

Nous avons révisé les dossiers de 178 patients consécutifs atteints de HSA traitée par chirurgie sur une période de trois ans. Les patients ayant présenté un OP diagnostiqué par un radiologiste ont été inclus dans l’étude. L’OP était considéré comme précoce s’il survenait dans les 12 heures de l‘HSA. La fonction cardiaque au moment de l’OP a été analysée au moyen des critères hémodynamiques et échocardiographiques de la dysfonction systolique et diastolique. Un OP a été observé chez 42 patients (28,8%) et il était souvent tardif (89,4%). La fréquence de manifestations d’atteinte cardiaque pendant l’OP variait de 40% à 100%.

Résultats et conclusions:

Un OP survient chez 28,8% des patients suite à une HSA et il est souvent tardif. On observe fréquemment une dysfonction cardiaque tant systolique que diastolique pendant l’HSA, ce qui pourrait contribuer à la genèse de l’OP après l’HSA.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 32 , Issue 2 , May 2005 , pp. 178 - 185
Copyright
Copyright © The Canadian Journal of Neurological 2005

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