Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice
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...
| 出版年: | Brain and Spine |
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| 主要な著者: | , , , , , , , , , , |
| フォーマット: | 論文 |
| 言語: | 英語 |
| 出版事項: |
Elsevier
2023-01-01
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| 主題: | |
| オンライン･アクセス: | http://www.sciencedirect.com/science/article/pii/S277252942300019X |
| _version_ | 1850140065823457280 |
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| author | Iftakher Hossain Alexander Younsi Ana Maria Castaño Leon Laura Lippa Péter Tóth Nicole Terpolilli Lovisa Tobieson Francesco Latini Andreas Raabe Bart Depreitere Elham Rostami |
| author_facet | Iftakher Hossain Alexander Younsi Ana Maria Castaño Leon Laura Lippa Péter Tóth Nicole Terpolilli Lovisa Tobieson Francesco Latini Andreas Raabe Bart Depreitere Elham Rostami |
| author_sort | Iftakher Hossain |
| collection | DOAJ |
| container_title | Brain and Spine |
| description | 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. |
| format | Article |
| id | doaj-art-43510f2a2d4b453c8eba2d4b950196f9 |
| institution | Directory of Open Access Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| spelling | doaj-art-43510f2a2d4b453c8eba2d4b950196f92025-08-19T23:49:34ZengElsevierBrain and Spine2772-52942023-01-01310173110.1016/j.bas.2023.101731Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practiceIftakher Hossain0Alexander Younsi1Ana Maria Castaño Leon2Laura Lippa3Péter Tóth4Nicole Terpolilli5Lovisa Tobieson6Francesco Latini7Andreas Raabe8Bart Depreitere9Elham Rostami10Neurocenter, Department of Neurosurgery, Turku University Hospital, Turku, Finland; Department of Clinical Neurosciences, Neurosurgery Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, United KingdomDepartment of Neurosurgery, University Hospital Heidelberg, Heidelberg, GermanyDepartment of Neurosurgery, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, SpainDepartment of Neurosurgery, Ospedale Niguarda, Milano, ItalyDepartment of Neurosurgery, University of Pecs, HungaryDepartment of Neurosurgery, Munich University Hospital, Munich, GermanyDepartment of Neurosurgery of Linköping, Linköping University, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, SwedenDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Neurosurgery, University Hospitals Leuven, Leuven, BelgiumDepartment of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden; Department of Neuroscience, Karolinska Institute, Stockholm, Sweden; Corresponding author. Department of Neurosurgery, Uppsala University Hospital, Sweden.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.http://www.sciencedirect.com/science/article/pii/S277252942300019XSubarachnoid hemorrhageEarly mobilizationHead-of-bed elevationCerebral vasospasm |
| spellingShingle | Iftakher Hossain Alexander Younsi Ana Maria Castaño Leon Laura Lippa Péter Tóth Nicole Terpolilli Lovisa Tobieson Francesco Latini Andreas Raabe Bart Depreitere Elham Rostami Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice Subarachnoid hemorrhage Early mobilization Head-of-bed elevation Cerebral vasospasm |
| title | Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice |
| title_full | Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice |
| title_fullStr | Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice |
| title_full_unstemmed | Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice |
| title_short | Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice |
| title_sort | huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage a european survey of practice |
| topic | Subarachnoid hemorrhage Early mobilization Head-of-bed elevation Cerebral vasospasm |
| url | http://www.sciencedirect.com/science/article/pii/S277252942300019X |
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