Head of Bed Elevation During Vasospasm Following Aneurysmal Subarachnoid Hemorrhage

2.50
Hdl Handle:
http://hdl.handle.net/10755/158298
Type:
Presentation
Title:
Head of Bed Elevation During Vasospasm Following Aneurysmal Subarachnoid Hemorrhage
Abstract:
Head of Bed Elevation During Vasospasm Following Aneurysmal Subarachnoid Hemorrhage
Conference Sponsor:Western Institute of Nursing
Conference Year:2003
Author:Blissitt, Patricia
P.I. Institution Name:University of Pennsylvania, School of Medicine, Department of Anesthesia
Contact Address:3400 Spruce Street, Dulles Building 7th Floor, Philadelphia, PA, 19104, USA
Purpose: This study was conducted to determine the effect of head of bed elevation on mild or moderate vasospasm following aneurysmal subarachnoid hemorrhage. Background: In the patient with aneurysmal subarachnoid hemorrhage, a delicate balance exists between preventive measures to decrease the consequences of immobility and the need to support optimal cerebral perfusion to prevent secondary brain injury. Based on tradition and consensus in individual institutions, the degree of head elevation during vasospasm has been limited by some clinicians in an attempt to minimize vasospasm and/or it sequelae. As a result, some individuals have remained on bedrest for weeks. However, prior to this study, no scientific investigation has been conducted to demonstrate the effect of head of bed elevation on vasospasm following aneurysmal subarachnoid hemorrhage: Methods: This study is descriptive and quasi-experimental. Twenty subjects, between days 3 and 14 post aneurysmal subarachnoid hemorrhage in mild or moderate vasospasm, underwent head of bed elevations in a 0-20-45-0 degree sequence. Middle cerebral artery flow velocities and middle cerebral artery flow velocity to internal carotid artery flow velocity ratios, the determinants of cerebral vasospasm, were recorded in each position using transcranial Doppler technology. Alpha was set at <.05. Descriptive and inferential statistics were computed. Results: No patterns or trends were found that indicate head of bed elevation increases vasospasm. As a group, there were no statistically significant differences within subjects at the different head positions. In addition, no individuals increased to severe vasospasm with head of bed elevations at 20 and 45 degrees. Conclusions: In general, increasing the head of the bed did not cause harmful changes in cerebral blood flow. The fact that one individual did experience an increase from mild to moderate vasospasm indicates the value of being able to monitor vasospasm during head of bed elevation. Additional studies with larger sample sizes, longer duration of head of bed elevations, and/or increased head of bed elevations are warranted. (Funding: NINR/University of Washington School of Nursing Biobehavioral Training Grant # 5 T32 NR01706-04)
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHead of Bed Elevation During Vasospasm Following Aneurysmal Subarachnoid Hemorrhageen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158298-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Head of Bed Elevation During Vasospasm Following Aneurysmal Subarachnoid Hemorrhage </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Blissitt, Patricia</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Pennsylvania, School of Medicine, Department of Anesthesia</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3400 Spruce Street, Dulles Building 7th Floor, Philadelphia, PA, 19104, USA</td></tr><tr><td colspan="2" class="item-abstract">Purpose: This study was conducted to determine the effect of head of bed elevation on mild or moderate vasospasm following aneurysmal subarachnoid hemorrhage. Background: In the patient with aneurysmal subarachnoid hemorrhage, a delicate balance exists between preventive measures to decrease the consequences of immobility and the need to support optimal cerebral perfusion to prevent secondary brain injury. Based on tradition and consensus in individual institutions, the degree of head elevation during vasospasm has been limited by some clinicians in an attempt to minimize vasospasm and/or it sequelae. As a result, some individuals have remained on bedrest for weeks. However, prior to this study, no scientific investigation has been conducted to demonstrate the effect of head of bed elevation on vasospasm following aneurysmal subarachnoid hemorrhage: Methods: This study is descriptive and quasi-experimental. Twenty subjects, between days 3 and 14 post aneurysmal subarachnoid hemorrhage in mild or moderate vasospasm, underwent head of bed elevations in a 0-20-45-0 degree sequence. Middle cerebral artery flow velocities and middle cerebral artery flow velocity to internal carotid artery flow velocity ratios, the determinants of cerebral vasospasm, were recorded in each position using transcranial Doppler technology. Alpha was set at &lt;.05. Descriptive and inferential statistics were computed. Results: No patterns or trends were found that indicate head of bed elevation increases vasospasm. As a group, there were no statistically significant differences within subjects at the different head positions. In addition, no individuals increased to severe vasospasm with head of bed elevations at 20 and 45 degrees. Conclusions: In general, increasing the head of the bed did not cause harmful changes in cerebral blood flow. The fact that one individual did experience an increase from mild to moderate vasospasm indicates the value of being able to monitor vasospasm during head of bed elevation. Additional studies with larger sample sizes, longer duration of head of bed elevations, and/or increased head of bed elevations are warranted. (Funding: NINR/University of Washington School of Nursing Biobehavioral Training Grant # 5 T32 NR01706-04) </td></tr></table>en_GB
dc.date.available2011-10-26T20:42:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:42:23Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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