Blood Pressure Treatment in ICU Patients With Subarachniodal Haemorrhage.

Study Overview
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Brief Summary
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An MRI study to examine the relationship between blood pressure and cerebral blood flow in patients with subarachnoidal hemorrhage and suspect or verified vasospasm.

Detailed Description
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Subarachnoidal hemorrhage (SAH) is a type of stroke with high mortality rates and often requires care at the intensive care unit. Cerebral blood flow (CBF) needs to be ensured so that the brain receives optimal nourishment, and this is largely controlled by regulating blood pressure (BP) using medications that affect the heart and blood vessels. Approximately 3-7 days after SAH onset, vasospasm (SAH-V) can occur. Treatment usually includes maintaining blood pressure (BP) above a certain threshold to achieve adequate cerebral blood flow (CBF). An important component of raising BP is increasing vascular resistance using vasoconstrictive medications, which paradoxically can decrease CBF. Our objective is to investigate the correlation between BP changes and their impact on CBF in patients with suspect or verified SAH-V using MRO. To achieve our purpose, we plan to examine the relationship between BP and CBF in patients with SAH-V who require neuro-intensive care. For measuring CBF, we will use MRI with two different MRI techniques: phase-contrast MRI and arterial spin labeling. Flow measurement with MRI: Baseline images will be acquired at baseline blood pressure. Mean arterial pressure (MAP) will be increased using norepinephrine. New images will be acquired when MAP is increased by approximately 20-30% from the baseline. All BP levels will be maintained within clinically acceptable ranges. All data will be recorded in the patient's medical record, and MRI images will be processed at a later stage.

Official Title
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Blood Pressure Treatment in ICU Patients With Subarachniodal Haemorrhage. -Can Blood Pressure be Used as a Surrogate Marker for Blood Flow

Conditions
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Blood Pressure, Subarachnoid Hemorrhage, Aneurysm Cerebral

Intervention / Treatment
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* Other: Blood pressure elevation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Coiled or clipped aneurysm Suspected or confirmed vasospasm Exclusion Criteria: BMI >30 Pregnancy Pacemaker or other MRI contraindications Severe congestive heart failure (NYHA III-IV) or cardiac arrhythmia. Severe respiratory failure or FiO2 >0.6 Severe kidney failure

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cerebral blood flow<br>Change in cerebral blood flow with increased systemic blood pressure | Other: Blood pressure elevation<br>* Increasing systemic blood pressure for measurement of cerebral blood flow changes<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cerebral blood flow | mL/min as measured by MRI | 1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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magnetic resonance imaging, norepinephrine, blood flow