Triple "H" therapy does not increase cerebral blood flow after induced subarachnoid hemorrhage in pigs.: Results of a pilot 99mTC-HMPAO-single photon emission computed tomography study

The so-called triple "H" therapy (THT) is routinely used to treat or to prevent cerebral vasospasm after subarachnoid hemorrhage (SAH). The three H's stand for hypervolemia, hemodilution and hypertension. Although no prospective, randomized, controlled clinical study really demonstrates a better outcome after SAH, there is a widespread use of THT. On the other hand literature reports complications like pulmonary edema, myocardial ischemia and cerebal edema and even animal studies are controversial. After reaching a significant increase of cerebral blood flow (CBF) after induced SAH by electrical stimulation of the Gasserian ganglion in a SPECT perfusion study [2] we used the same protocol to assess the effect of THT in pigs.