2.50
Hdl Handle:
http://hdl.handle.net/10755/163744
Category:
Abstract
Type:
Presentation
Title:
Vasospasm Detection Following Subarachnoid Hemorrhage Using Cerebral Oximetry
Author(s):
Kerr, Mary
Author Details:
Mary Kerr, PhD, Research Assistant Professor, University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania, USA, email: mek1@pitt.edu
Abstract:
Introduction: Cerebral vasospasm (CV) occurs in 30-60% of individuals who survive a severe subarachnoid hemorrhage (SAH) within the first 14 days post hemorrhage, increasing the risk of neurologic deficit or death. The current intermittent techniques, neurologic examination every 2 hours or daily transcranial doppler, are inadequate for the early detection of CV. Hypothesis: The purpose of this study was to determine the sensitivity of continuous, noninvasive cerebral oximetry by near infrared spectroscopy (NIRS) for detecting CV. Methods: This prospective study involved 25 subjects with aneurysmal SAH documented by CT head scans with a Hunt and Hess grade > 3 or a Fisher grade > 2. Bilateral cerebral oximetry using NIRS (INVOS4100, Somanetics Corp.) was used to continuously monitor regional cerebral oxygenation (rSO2) over the frontal/temporal cortex from day 5-10 post bleed. Physiological variables were continuously recorded via bedside computerized acquisition at a rate of 1/min. rSO2 levels < 50 were examined in relation to CV verified by arteriogram. Results: Eighteen subjects (72%) experienced moderate or severe vasospasm in > 1 vessel. rSO2 was < 50 for > 30 minutes in 18 subjects (72%). Twelve subjects (66%) had moderate or severe vasospasm and 11/12 (92%) showed neurologic deterioration. Seven subjects had rSO2 > 50 with no vasospasm (n=1), moderate vasospasm without clinical deterioration (n=4), or severe vasospasm with clinical deterioration (n=2). Sensitivity and specificity for rSO2 prediction of vasospasm was 67 % and 14% but improved to 85% and 33% in patients that experienced clinical deterioration. Conclusions: Cerebral oximetry was most predictive of vasospasm associated with neurologic deterioration secondary to multi vessel CV. It is not, however, sufficiently sensitive to detect compensated CV that does not restrict oxygen delivery. Implications for nursing practice and knowledge development: Healthcare continues to progress into the future with technological advancements in bedside monitoring and testing. In addition to our advancements, these results suggest that it is the combination of these devices along with the bedside nursing assessment that offer the best predictors of patient outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
ENRS 13th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Atlantic City, New Jersey, USA
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.titleVasospasm Detection Following Subarachnoid Hemorrhage Using Cerebral Oximetryen_GB
dc.contributor.authorKerr, Maryen_US
dc.author.detailsMary Kerr, PhD, Research Assistant Professor, University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania, USA, email: mek1@pitt.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163744-
dc.description.abstractIntroduction: Cerebral vasospasm (CV) occurs in 30-60% of individuals who survive a severe subarachnoid hemorrhage (SAH) within the first 14 days post hemorrhage, increasing the risk of neurologic deficit or death. The current intermittent techniques, neurologic examination every 2 hours or daily transcranial doppler, are inadequate for the early detection of CV. Hypothesis: The purpose of this study was to determine the sensitivity of continuous, noninvasive cerebral oximetry by near infrared spectroscopy (NIRS) for detecting CV. Methods: This prospective study involved 25 subjects with aneurysmal SAH documented by CT head scans with a Hunt and Hess grade > 3 or a Fisher grade > 2. Bilateral cerebral oximetry using NIRS (INVOS4100, Somanetics Corp.) was used to continuously monitor regional cerebral oxygenation (rSO2) over the frontal/temporal cortex from day 5-10 post bleed. Physiological variables were continuously recorded via bedside computerized acquisition at a rate of 1/min. rSO2 levels < 50 were examined in relation to CV verified by arteriogram. Results: Eighteen subjects (72%) experienced moderate or severe vasospasm in > 1 vessel. rSO2 was < 50 for > 30 minutes in 18 subjects (72%). Twelve subjects (66%) had moderate or severe vasospasm and 11/12 (92%) showed neurologic deterioration. Seven subjects had rSO2 > 50 with no vasospasm (n=1), moderate vasospasm without clinical deterioration (n=4), or severe vasospasm with clinical deterioration (n=2). Sensitivity and specificity for rSO2 prediction of vasospasm was 67 % and 14% but improved to 85% and 33% in patients that experienced clinical deterioration. Conclusions: Cerebral oximetry was most predictive of vasospasm associated with neurologic deterioration secondary to multi vessel CV. It is not, however, sufficiently sensitive to detect compensated CV that does not restrict oxygen delivery. Implications for nursing practice and knowledge development: Healthcare continues to progress into the future with technological advancements in bedside monitoring and testing. In addition to our advancements, these results suggest that it is the combination of these devices along with the bedside nursing assessment that offer the best predictors of patient outcomes.en_GB
dc.date.available2011-10-27T11:13:03Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:13:03Z-
dc.conference.date2001en_US
dc.conference.nameENRS 13th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationAtlantic City, New Jersey, USAen_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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