What is Triple H therapy in SAH?

The combination of induced hypertension, hypervolemia, and hemodilution (triple-H therapy) is often utilized to prevent and treat cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH).

How is intracranial vasospasm treated?

Nimodipine has been recommended as first-line medical treatment for preventing post-aSAH cerebral vasospasm. It is usually given orally at a dosage of 60 mg every 4 hours for 21 days after the initial subarachnoid hemorrhage.

What is hemodilution in SAH?

Hypervolemic hemodilution is a new therapy that is used in the patient with decreased CBF. The therapy is designed to decrease the hematocrit and the viscosity of blood, subsequently increasing CBF.

What medication may be injected during an endovascular procedure for short term vasospasm relief?

Vasospasm is treated by injecting medication (including verapamil or nimodipine) into the catheter, which is positioned very close to the narrowed artery, to reverse the spasm. Alternatively, a tiny balloon will be inserted through the catheter and into the artery to stretch open the artery (angioplasty).

When is Triple H therapy used?

Hypertension, hypervolemia, and hemodilution (triple-H therapy) is often utilized to prevent and treat cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH).

What is a normal Lindegaard ratio?

A Lindegaard ratio of 3–6 is indicative of mild to moderate vasospasm, and a ratio greater than 6.0 is indicative of severe vasospasm (Fig 10). Elevated flow velocities with a Lindegaard ratio of less than 3.0 are suggestive of hyperemia or another physiologic or induced state (1,6,12).

Why is nimodipine used for SAH?

Nimodipine is used to decrease brain damage that may be caused by a subarachnoid hemorrhage (bleeding in the space surrounding the brain that occurs when a weakened blood vessel in the brain bursts). Nimodipine is in a class of medications called calcium channel blockers.

What should be the target blood pressure prior to obliteration of aneurysm?

Treatment in a neurovascular center Keeping the systolic blood pressure below 140 mmHg is recommended (20).

Does Triple H therapy work?

Hyperdynamic therapy, also called triple-H therapy, is the standard treatment and prophylaxis for aneurysmal-associated vasospasm. In patients who are able to tolerate cardiopulmonary stressors induced by this therapy, it is of benefit as a modality for prevention and treatment of delayed ischemic neurologic deficit.

What is Triple H therapy protocol?

Triple H therapy. We increase the blood pressure to improve cerebral perfusion of the brain and to prevent ischaemia or vasospasm. The doctor usually sets a BP or MAP parameters to maintain and we nurses, should not be hesistant to ask the doctors about parameters. And I think the Triple H therapy plays a very important role in treating SAH.

What is triple aneurysm?

An abdominal aortic aneurysm (AAA, or “triple A”) occurs when this type of vessel weakening happens in the portion of the aorta that runs through the abdomen.

What is a triple aortic aneurysm?

Abdominal aortic aneurysm (AAA or triple A) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, back, or leg pain may occur. Large aneurysms can sometimes be felt by pushing on the abdomen.