Triple H therapy in reference to what........in the ED/med-surg world triple H theray meant an enema and stood for
"High, Hot, and a helluva lot".
In the neuroworld......Triple H therapy is part of the standard care for patient's that have had a subarachnoid hemmorhage from an aneurysm rupture and then had a repair....either clipping or coiling.
The H's are: Hypertension, Hypervolemia and Hemodilution. So, essentially what they are attempting to do is to keep the vessels in the brain open so that they can't go into vasospasm, which is a HUGE, HUGE risk in these patients. Also used to prevent spasm is Nimodipine (a calcium channel blocker).
Where I worked we would at times keep MAPs (mean arterial pressure) as high as 110, assuming the aneurysm is well secured. The stroke that you're trying to prevent is an ischemic stroke due to the vasospasm clamping down the arteries. So you're willing to risk a high blood pressure for a short period to prevent that.
Think of it this way:
if you're trying to push more liquid (blood) through a tube (a cerebral artery) there are three things that you can do.
You can load up the tube with more liquid, pump up the volume- that's hypervolemia.
You can make the liquid less viscous so it slides through more easily, thinned out - that's hemodilution.
And finally, you can push harder - that's hypertension.
All three have their risks. Hypervolemia risks wet lungs - up to and including pulmonary edema. Hemodilution risks depriving tissue of oxygen, if the H/H is low enough. And, hypertension risks hemorrhagic stroke. It's always a trade-off on the risk/reward graph.
Vasospasm After Aneurysmal Subarachnoid Hemorrhage
I hope this helps.