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- …

Hypervolaemia, hypertension, and haemodilution (triple-H) therapy in an intensive-care setting has been shown in some studies to improve outcome and is an accepted means of treatment, although a randomized controlled trial has never been undertaken.

Triple-H therapy and its separate components (hypervolemia, hemodilution, and hypertension) aim to increase cerebral perfusion in subarachnoid haemorrhage (SAH) patients with delayed cerebral ischemia. We systematically reviewed the literature on the effect of triple-H components on cerebral perfusion in SAH patients.

Hypervolemic hypertensive hemodilution (3H-therapy) applied to patients operated on in the acute period of aneurysmal SAH was effective in increasing cardiac output, central venous pressure, systemic arterial pressure and hence cerebral perfusion with the minimum number of complications unassociated with the use of this technique.

选择合适的适应症很重要，对于CT已经证实的脑梗死，3H不合适，也无效。 影响效果的主要问题是并发症，应该严密监测各项指标，缺血症状消失后尽早停止，可采用心排血量而不是平均动脉压作为生理终点。 监测：导尿，动脉血压监测，PA或Picco. 评价：TCD，CT-perfusion, Xe-CT. 目标：为避免严重的脑水肿和出血性梗死，不要在大面积脑水肿和缺血性脑梗死伴DIND的病人使用。 尤其SAH后6天内。 CVP8－12mmHg/PCWP18－20mmHg. (未夹闭AN,CVP 6-10, PCWP6 …

2003年11月1日 · Triple-H therapy, including the induction of hypertension, was originally used in patients with aneurysmal subarachnoid hemorrhage after aneurysm clipping; this therapy relieves cerebral...

2003年10月1日 · Hypervolaemia, hypertension, and haemodilution (triple-H) therapy in an intensive-care setting has been shown in some studies to improve outcome and is an accepted means of treatment, although a randomized controlled trial has never been undertaken.

This study concluded that combining continuous cerebrospinal drainage and intermittent intrathecal UK injection therapy is a relatively simple and effective method for symptomatic vasospasm prophylaxis in patients with aneurysmal 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).

2019年7月21日 · Current Practices of 3-H Prophylaxis and Therapy in Patients with SAH • No consensus on how to administer therapy • No agreement on clinical endpoints to guide therapy • No clear patterns or trends for initiating prophylactic therapy • Variability in the administration of prophylactic 3-H derives from the lack of evidence and guidelines.