Hypotensive effect of nimodipine during treatment for aneurysmal subarachnoid haemorrhage

Details

Serval ID
serval:BIB_C7E937B3332E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Hypotensive effect of nimodipine during treatment for aneurysmal subarachnoid haemorrhage
Journal
Acta Neurochirurgica
Author(s)
Porchet  F., Chiolero  R., de Tribolet  N.
ISSN
0001-6268 (Print)
Publication state
Published
Issued date
1995
Volume
137
Number
1-2
Pages
62-9
Notes
Journal Article
Abstract
To determine the incidence of induced systemic hypotension in patients after aneurysmal subarachnoid haemorrhage (SAH) and nimodipine treatment 87 consecutive cases were reviewed. The patients were managed according to the same Nimodipine treatment protocol. After confirmation of SAH the nimodipine treatment was started as a continuous intravenous perfusion at a dosage of 0.5 mg/h and gradually increased every 6 hours if haemodynamically tolerated until the maintenance dose of 2 mg/h was reached. Median systemic pressure was continuously measured and tolerated until a lowest limit of 75 mmHg. In 31 patients (36%) hypotension with values below 75 mmHg during at least 30 minutes was noted and needed Nimodipine reduction. Intravenous Nimodipine administration was responsible for hypotension in 26 cases as compared to 5 cases due to oral administration. 38% of all patients required support by vaso-active agents (Dopamine or Nor-adrenaline). There was no statistically significant difference of incidence of delayed ischaemic deterioration comparing the Nimodipine-reduction group with the normal dose group. This study demonstrates that a considerable risk exists of Nimodipine induced hypotension in intravenous administration despite gradually increasing the doses. Correction of hypotension through further induced hypervolaemia accompanied by vasoactive agents can lead to critical haemodynamic situations. We therefore recommend oral Nimodipine administration.
Keywords
Administration, Oral Adult Aged Aneurysm, Ruptured/*drug therapy Blood Pressure/drug effects Brain/blood supply Calcium Channel Blockers/administration & dosage/*adverse effects Dose-Response Relationship, Drug Female Hemodynamic Processes/drug effects Humans Hypotension/*chemically induced Infusions, Intravenous Intracranial Aneurysm/*drug therapy Male Middle Aged Neurologic Examination/drug effects Nimodipine/administration & dosage/*adverse effects Subarachnoid Hemorrhage/*drug therapy Treatment Outcome
Pubmed
Web of science
Create date
24/01/2008 16:52
Last modification date
20/08/2019 15:43
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