FIG. 1.

Patient physiology and vasopressor dosage during treatment of vasospasm. Key physiological measures were plotted during the management of cerebral vasospasm. Values for postrupture days 10 to 15 are shown. Measures are time aligned, and 1-minute values are plotted, including cerebral P_btO₂ measures (black, goal >20 mm Hg) and blood flow measures (gray, goal >15 mL/100 g/min) obtained with the Licox and QFlow 500 probes, respectively, as well as mean arterial blood pressure as measured continuously with an arterial line (red), S_pO₂ values measured with a pulse oximeter (blue), and end-tidal CO₂ (purple). Infusion dosages of norepinephrine, phenylephrine, and vasopressin are shown in the bottom row (black, red, and blue, respectively). Vertical gray lines denote midnights. The wide gaps in the data reflect the intervals during which interventional cerebral angiography was performed, and the narrow gaps on days 12 and 15 reflect the time when computed tomography was performed. The P_btO₂ values increased markedly after the first administration of intrathecal nicardipine despite dropping S_pO₂ and a decrease in phenylephrine dosage at this time. The perfusion increase noted after intraarterial therapy on day 13 was less than that noted with intrathecal nicardipine administration.