Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice.

Autor:	Hossain I; Neurocenter, Department of Neurosurgery, Turku University Hospital, Turku, Finland.; Department of Clinical Neurosciences, Neurosurgery Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom., Younsi A; Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany., Castaño Leon AM; Department of Neurosurgery, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain., Lippa L; Department of Neurosurgery, Ospedale Niguarda, Milano, Italy., Tóth P; Department of Neurosurgery, University of Pecs, Hungary., Terpolilli N; Department of Neurosurgery, Munich University Hospital, Munich, Germany., Tobieson L; Department of Neurosurgery of Linköping, Linköping University, Linköping, Sweden.; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden., Latini F; Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden., Raabe A; Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Depreitere B; Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium., Rostami E; Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.; Department of Neuroscience, Karolinska Institute, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	Brain & spine [Brain Spine] 2023 Mar 21; Vol. 3, pp. 101731. Date of Electronic Publication: 2023 Mar 21 (Print Publication: 2023).
DOI:	10.1016/j.bas.2023.101731
Abstrakt:	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. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Iftakher Hossain reports financial support was provided by The 10.13039/100008723Finnish Medical Foundation, The 10.13039/501100004212Päivikki and Sakari Sohlberg Foundation, The 10.13039/501100007417Paulo Foundation, The 10.13039/501100003125Finnish Cultural Foundation. Lovisa Tobiesson reports financial support was provided by The 10.13039/501100008590Swedish Stroke Association, Swedish State Support for Clinical Research. Elham Rostami reports financial support was provided by Wallenberg Clinical Fellow, Swedish government and the County Councils, The ALF agreement. (© 2023 The Authors.)
Databáze:	MEDLINE
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