Triple-H" therapy for cerebral vasospasm following subarachnoid hemorrhage.

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). Although this paradigm has gained widespread acceptance over the past 20 years, the efficacy of triple-H therapy and its precise role in the management of the acute phase of SAH remains uncertain. In addition, triple-H therapy may carry significant medical morbidity, including pulmonary edema, myocardial ischemia, hyponatremia, renal medullary washout, indwelling catheter-related complications, cerebral hemorrhage, and cerebral edema. This review examines the evidence underlying the implementation of triple-H therapy, and makes practical recommendations for the use of this therapy in patients with aneurysmal SAH.

Citation

Kendall H Lee, Timothy Lukovits, Jonathan A Friedman. Triple-H" therapy for cerebral vasospasm following subarachnoid hemorrhage. Neurocritical care. 2006;4(1):68-76

Mesh Tags

PMID: 16498198

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