Effect of Continuous Magnesium Infusion on Cerebral Vasospasm and 3 Month Outcomes Following Subarachnoid Hemorrhage

2.50
Hdl Handle:
http://hdl.handle.net/10755/163511
Category:
Abstract
Type:
Presentation
Title:
Effect of Continuous Magnesium Infusion on Cerebral Vasospasm and 3 Month Outcomes Following Subarachnoid Hemorrhage
Author(s):
Crago, Elizabeth A.; Levy, Elad; Kerr, Mary; Horowitz, Mike; Yonas, Howard; Kassam, Amin; Stippler, Martina
Author Details:
Elizabeth Crago, RN, MSN, Research Associate, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: ecrago@pitt.edu; Elad Levy, MD; Mary Kerr, PhD, RN; Mike Horowitz, MD; Howard Yonas, MD; Amin Kassam, MD; Martina Stippler, MD
Abstract:
Purpose: Despite advances in treatment, cerebral vasospasm (CV) remains a common complication after subarachnoid hemorrhage (SAH). Calcium (Ca++) dysregulation of smooth muscle may contribute to CV after SAH and magnesium (Mg++), a Ca++ antagonist, alters smooth muscle contraction. The purpose of this study is to determine whether continuous Mg++ infusion decreases CV and improves outcomes following SAH. Methods: This study used a comparative matched cohort of subjects recruited during an on-going NIH funded study (#RO1NR04339). Adult SAH patients (n=38) who received Mg++ infusions (12 gm in 500cc NSS at 21cc/hr for up to 10 days) were matched with 38 patients without Mg++ on age, race, gender, treatment option, Fisher and Hunt and Hess grades [(mean age=54.6)(71% female, n=54)(92% Caucasian, n=70)]. All patients received Nimodipine as standard of care. CV was identified from angiograms, CT angiogram reports, or elevated transcranial Dopplers associated with a neurological change. Outcomes were assessed by telephone or face-to-face interview at 3 months using Modified Rankin Scale (MRS) and Glasgow Outcome Scale (GOS). Analyses were conducted using descriptive, ANOVA, and Chi square analysis. Results: Patients with Mg++ infusion had significantly less CV (n=10, 26%) than those without Mg++ (n=20, 53%) [(?2 = 5.51, p= .019,)]. Four patients (10%) in the Mg++ group died before discharge versus 7 (18%) without Mg++ [(? 2 = .957, p= .328,) OR = 1.7(95% CI = .56-5.5)]. Of the 56 patients with 3-month outcome data available, patients with Mg++ (n=28) showed trends of less disability and improved outcomes by MRS (? 2 = 4.99, p= .082) uncaptured by GOS (? 2 = .173, p= .785,). Conclusions and Implications: Mg++ infusion is potentially an effective therapy when used with Nimodipine in the prevention of CV following SAH and may help to improve outcomes and justifies the conduction of a larger randomized clinical trial.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
17th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
New York, New York, USA
Description:
�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New York
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEffect of Continuous Magnesium Infusion on Cerebral Vasospasm and 3 Month Outcomes Following Subarachnoid Hemorrhageen_GB
dc.contributor.authorCrago, Elizabeth A.en_US
dc.contributor.authorLevy, Eladen_US
dc.contributor.authorKerr, Maryen_US
dc.contributor.authorHorowitz, Mikeen_US
dc.contributor.authorYonas, Howarden_US
dc.contributor.authorKassam, Aminen_US
dc.contributor.authorStippler, Martinaen_US
dc.author.detailsElizabeth Crago, RN, MSN, Research Associate, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: ecrago@pitt.edu; Elad Levy, MD; Mary Kerr, PhD, RN; Mike Horowitz, MD; Howard Yonas, MD; Amin Kassam, MD; Martina Stippler, MDen_US
dc.identifier.urihttp://hdl.handle.net/10755/163511-
dc.description.abstractPurpose: Despite advances in treatment, cerebral vasospasm (CV) remains a common complication after subarachnoid hemorrhage (SAH). Calcium (Ca++) dysregulation of smooth muscle may contribute to CV after SAH and magnesium (Mg++), a Ca++ antagonist, alters smooth muscle contraction. The purpose of this study is to determine whether continuous Mg++ infusion decreases CV and improves outcomes following SAH. Methods: This study used a comparative matched cohort of subjects recruited during an on-going NIH funded study (#RO1NR04339). Adult SAH patients (n=38) who received Mg++ infusions (12 gm in 500cc NSS at 21cc/hr for up to 10 days) were matched with 38 patients without Mg++ on age, race, gender, treatment option, Fisher and Hunt and Hess grades [(mean age=54.6)(71% female, n=54)(92% Caucasian, n=70)]. All patients received Nimodipine as standard of care. CV was identified from angiograms, CT angiogram reports, or elevated transcranial Dopplers associated with a neurological change. Outcomes were assessed by telephone or face-to-face interview at 3 months using Modified Rankin Scale (MRS) and Glasgow Outcome Scale (GOS). Analyses were conducted using descriptive, ANOVA, and Chi square analysis. Results: Patients with Mg++ infusion had significantly less CV (n=10, 26%) than those without Mg++ (n=20, 53%) [(?2 = 5.51, p= .019,)]. Four patients (10%) in the Mg++ group died before discharge versus 7 (18%) without Mg++ [(? 2 = .957, p= .328,) OR = 1.7(95% CI = .56-5.5)]. Of the 56 patients with 3-month outcome data available, patients with Mg++ (n=28) showed trends of less disability and improved outcomes by MRS (? 2 = 4.99, p= .082) uncaptured by GOS (? 2 = .173, p= .785,). Conclusions and Implications: Mg++ infusion is potentially an effective therapy when used with Nimodipine in the prevention of CV following SAH and may help to improve outcomes and justifies the conduction of a larger randomized clinical trial.en_GB
dc.date.available2011-10-27T11:08:49Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:08:49Z-
dc.conference.date2005en_US
dc.conference.name17th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationNew York, New York, USAen_US
dc.description�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New Yorken_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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