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In turn, both complications are related to poor outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). We aimed to analyze the effect of PaCO2 levels on the course and outcome of aSAH. All patients of a single institution treated for aSAH over 13.5\u00a0years were included (n\u2009=\u2009633). Daily PaCO2 values from arterial blood gas measurements were recorded for up to 2\u00a0weeks after ictus. The study endpoints were: delayed cerebral ischemia (DCI), need for decompressive craniectomy due to increased intracranial pressure\u2009&gt;\u200920\u00a0mmHg refractory to conservative treatment and poor outcome at 6-months follow-up (modified Rankin scale\u2009&gt;\u20092). By correlations with the study endpoints, clinically relevant cutoffs for the 14-days mean values for the lowest and highest daily PaCO2 levels were defined by receiver operating characteristic curve analysis. Association with the study endpoints for the identifies subgroups was analyzed using multivariate analysis. The optimal range for PaCO2 values was identified between 30 and 38\u00a0mmHg. ASAH patients with poor initial condition (WFNS 4\/5) were less likely to show PaCO2 values within the range of 30\u201338\u00a0mmHg (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u20090.44). In the multivariate analysis, PaCO2 values between 30 and 38\u00a0mmHg were associated with a lower risk for decompressive craniectomy (<jats:italic>p<\/jats:italic>\u2009=\u20090.042, aOR\u2009=\u20090.27), DCI occurrence (<jats:italic>p<\/jats:italic>\u2009=\u20090.035; aOR\u2009=\u20090.50), and poor patient outcome (<jats:italic>p<\/jats:italic>\u2009=\u20090.004; aOR\u2009=\u20090.42). The data from this study shows an independent positive association between low normal mean PaCO2 values during the acute phase of aSAH and patients\u2019 outcome. This effect might be attributed to the reduction of intracranial hypertension and alterations in the cerebral blood flow.<\/jats:p>","DOI":"10.1038\/s41598-021-98462-2","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T10:03:06Z","timestamp":1632823386000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["PaCO2-management in the neuro-critical care of patients with subarachnoid hemorrhage"],"prefix":"10.1038","volume":"11","author":[{"given":"Marvin","family":"Darkwah Oppong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karsten H.","family":"Wrede","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro N.","family":"Santos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laur\u00e8l","family":"Rauschenbach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiemo F.","family":"Dinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yahya","family":"Ahmadipour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Pierscianek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Chihi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelius","family":"Deuschl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Sure","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramazan","family":"Jabbarli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"98462_CR1","doi-asserted-by":"publisher","first-page":"R1473","DOI":"10.1152\/ajpregu.91008.2008","volume":"296","author":"PN Ainslie","year":"2009","unstructured":"Ainslie, P. 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