Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case series
Objective: Pulmonary edema is a common complication in patients receiving clazonsentan. Here, we report our experience in managing fluid balance with loop diuretics in patients with aneurysmal subarachnoid hemorrhage (aSAH) treated with clazosentan. Methods: Patients with aSAH who received prophylac...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
KeAi Communications Co., Ltd.
2024-04-01
|
| Series: | Brain Hemorrhages |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589238X23000414 |
| _version_ | 1827300527482863616 |
|---|---|
| author | Yosuke Akamatsu Kohei Chida Kenya Miyoshi Daigo Kojima Jun-Ichi Nomura Kengo Setta Takayuki Chiba Takahiro Koji Shunrou Fujiwara Hiroshi Kashimura Yoshitaka Kubo Kuniaki Ogasawara |
| author_facet | Yosuke Akamatsu Kohei Chida Kenya Miyoshi Daigo Kojima Jun-Ichi Nomura Kengo Setta Takayuki Chiba Takahiro Koji Shunrou Fujiwara Hiroshi Kashimura Yoshitaka Kubo Kuniaki Ogasawara |
| author_sort | Yosuke Akamatsu |
| collection | DOAJ |
| description | Objective: Pulmonary edema is a common complication in patients receiving clazonsentan. Here, we report our experience in managing fluid balance with loop diuretics in patients with aneurysmal subarachnoid hemorrhage (aSAH) treated with clazosentan. Methods: Patients with aSAH who received prophylactic agents for vasospasm after aneurysm obliteration between June 2021 and April 2023 were enrolled. Fluid balance parameters and asymptomatic and symptomatic vasospasm and pulmonary edema incidence were compared in three periods: 1st period (fasudil therapy), 2nd period (clazosentan therapy alone), and 3rd period (clazosentan with loop diuretic therapy). Results: Fluid intake and urine volume during the 2nd and 3rd periods were considerably lesser than those during the 1st period. Asymptomatic vasospasm incidence was considerably lesser in the 3rd period than that in the 1st and 2nd periods. However, the incidences of symptomatic vasospasm and rescue endovascular treatment were comparable among the three groups. Although the clinical outcomes at the last follow-up were comparable among the three groups, pulmonary edema incidence was markedly higher during the 2nd period than that in the 1st and 3rd periods. Conclusion: Thus, proper management of fluid balance with clazosentan and diuretics would help in effective clazosentan therapy for vasospasm prophylaxis. |
| first_indexed | 2024-04-24T16:06:24Z |
| format | Article |
| id | doaj.art-6ffa8610f0bf4e67a42daed4bd92c60e |
| institution | Directory Open Access Journal |
| issn | 2589-238X |
| language | English |
| last_indexed | 2024-04-24T16:06:24Z |
| publishDate | 2024-04-01 |
| publisher | KeAi Communications Co., Ltd. |
| record_format | Article |
| series | Brain Hemorrhages |
| spelling | doaj.art-6ffa8610f0bf4e67a42daed4bd92c60e2024-04-01T04:04:29ZengKeAi Communications Co., Ltd.Brain Hemorrhages2589-238X2024-04-01527478Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case seriesYosuke Akamatsu0Kohei Chida1Kenya Miyoshi2Daigo Kojima3Jun-Ichi Nomura4Kengo Setta5Takayuki Chiba6Takahiro Koji7Shunrou Fujiwara8Hiroshi Kashimura9Yoshitaka Kubo10Kuniaki Ogasawara11Department of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, Japan; Department of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, Japan; Corresponding author at: Department of Neurosurgery, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Iwate 028-3694, Japan (Y. Akamatsu).Department of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanDepartment of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, JapanDepartment of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, JapanDepartment of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanDepartment of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanDepartment of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanDepartment of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanDepartment of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanDepartment of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, JapanDepartment of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanDepartment of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Iwate, JapanObjective: Pulmonary edema is a common complication in patients receiving clazonsentan. Here, we report our experience in managing fluid balance with loop diuretics in patients with aneurysmal subarachnoid hemorrhage (aSAH) treated with clazosentan. Methods: Patients with aSAH who received prophylactic agents for vasospasm after aneurysm obliteration between June 2021 and April 2023 were enrolled. Fluid balance parameters and asymptomatic and symptomatic vasospasm and pulmonary edema incidence were compared in three periods: 1st period (fasudil therapy), 2nd period (clazosentan therapy alone), and 3rd period (clazosentan with loop diuretic therapy). Results: Fluid intake and urine volume during the 2nd and 3rd periods were considerably lesser than those during the 1st period. Asymptomatic vasospasm incidence was considerably lesser in the 3rd period than that in the 1st and 2nd periods. However, the incidences of symptomatic vasospasm and rescue endovascular treatment were comparable among the three groups. Although the clinical outcomes at the last follow-up were comparable among the three groups, pulmonary edema incidence was markedly higher during the 2nd period than that in the 1st and 3rd periods. Conclusion: Thus, proper management of fluid balance with clazosentan and diuretics would help in effective clazosentan therapy for vasospasm prophylaxis.http://www.sciencedirect.com/science/article/pii/S2589238X23000414Symptomatic vasospasmClazosentanAneurysmal subarachnoid hemorrhage |
| spellingShingle | Yosuke Akamatsu Kohei Chida Kenya Miyoshi Daigo Kojima Jun-Ichi Nomura Kengo Setta Takayuki Chiba Takahiro Koji Shunrou Fujiwara Hiroshi Kashimura Yoshitaka Kubo Kuniaki Ogasawara Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case series Brain Hemorrhages Symptomatic vasospasm Clazosentan Aneurysmal subarachnoid hemorrhage |
| title | Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case series |
| title_full | Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case series |
| title_fullStr | Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case series |
| title_full_unstemmed | Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case series |
| title_short | Fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: A case series |
| title_sort | fluid balance management with loop diuretics in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan a case series |
| topic | Symptomatic vasospasm Clazosentan Aneurysmal subarachnoid hemorrhage |
| url | http://www.sciencedirect.com/science/article/pii/S2589238X23000414 |
| work_keys_str_mv | AT yosukeakamatsu fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT koheichida fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT kenyamiyoshi fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT daigokojima fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT junichinomura fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT kengosetta fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT takayukichiba fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT takahirokoji fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT shunroufujiwara fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT hiroshikashimura fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT yoshitakakubo fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries AT kuniakiogasawara fluidbalancemanagementwithloopdiureticsinpatientswithaneurysmalsubarachnoidhemorrhagetreatedwithclazosentanacaseseries |