Hossain, Iftakher; Younsi, Alexander; Castaño Leon, Ana Maria; Lippa, Laura; Tóth, Péter; Terpolilli, Nicole; Tobieson, Lovisa; Latini, Francesco; Raabe, Andreas; Depreitere, Bart; Rostami, Elham (2023). Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice. Brain and Spine, 3(101731), p. 101731. Elsevier 10.1016/j.bas.2023.101731
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INTRODUCTION
One of the major goals of neurointensive care is to prevent secondary injuries following aSAH. Bed rest and patient immobilization are practiced in order to decrease the risk of DCI.
RESEARCH QUESTION
To explore the current practices in place concerning the management of patients with aSAH, specifically, protocols and habits regarding restrictions of mobilization and HOB positioning.
MATERIAL AND METHODS
A survey was designed, modified, and approved by the panel of the Trauma & Critical Care section of the EANS to cover the practice of restrictions of patient mobilization and HOB positioning in patients with aSAH.
RESULTS
Twenty-nine physicians from 17 countries completed the questionnaire. The majority (79.3%) stated that non-secured aneurysm and the presence of an EVD were the factors related to the establishment of restriction of mobilization. The average duration of the restriction varied widely ranging between 1 and 21 days. The presence of an EVD (13.8%) was found to be the main reason to recommend restriction of HOB elevation. The average duration of restriction of HOB positioning ranged between 3 and 14 days. Rebleeding or complications related to CSF over-drainage were found to be related to these restrictions.
DISCUSSION AND CONCLUSION
Restriction of patient mobilization regimens vary widely in Europe. Current limited evidence does not support an increased risk of DCI rather the early mobilization might be beneficial. Large prospective studies and/or the initiative of a RCT are needed to understand the significance of early mobilization on the outcome of patients with aSAH.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery |
UniBE Contributor: |
Raabe, Andreas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2772-5294 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
30 Jun 2023 15:23 |
Last Modified: |
16 Jul 2023 02:26 |
Publisher DOI: |
10.1016/j.bas.2023.101731 |
PubMed ID: |
37383447 |
Uncontrolled Keywords: |
Cerebral vasospasm Early mobilization Head-of-bed elevation Subarachnoid hemorrhage |
BORIS DOI: |
10.48350/184265 |
URI: |
https://boris.unibe.ch/id/eprint/184265 |
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