Blood pressure reduction does not reduce perihematoma oxygenation: a CT perfusion study
Clinical Trials Monday, September 23rd, 2013Nature: September 18, 2013
Mahesh P Kate, Mikkel B Hansen, Kim Mouridsen, Leif Østergaard, Victor Choi, Bronwen E Gould, Rebecca McCourt, Michael D Hill, Andrew M Demchuk, Shelagh B Coutts, Dariush Dowlatshahi, Derek J Emery, Brian H Buck, Kenneth S Butcher and for the ICHADAPT Investigators
Abstract
Blood pressure (BP) reduction after intracerebral hemorrhage (ICH) is controversial, because of concerns that this may cause critical reductions in perihematoma perfusion and thereby precipitate tissue damage. We tested the hypothesis that BP reduction reduces perihematoma tissue oxygenation.Acute ICH patients were randomized to a systolic BP target of <150 or <180 mm Hg. Patients underwent CT perfusion (CTP) imaging 2 hours after randomization. Maps of cerebral blood flow (CBF), maximum oxygen extraction fraction (OEFmax), and the resulting maximum cerebral metabolic rate of oxygen (CMRO2max) permitted by local hemodynamics, were calculated from raw CTP data.Sixty-five patients (median (interquartile range) age 70 (20)) were imaged at a median (interquartile range) time from onset to CTP of 9.8 (13.6) hours. Mean OEFmax was elevated in the perihematoma region (0.44±0.12) relative to contralateral tissue (0.36±0.11; P<0.001). Read more
