Subarachnoid Hemorrhage
Conditions
Keywords
Early mobilization, Brain perfusion, Transcranial doppler, Near-infrared spectroscopy, Lung Ultrasound
Brief summary
The aim of the study is to evaluate the physiological response to out-of-bed mobilization in patients admitted to the intensive care unit for subarachnoid hemorrhage. More specifically, the aim is to measure the impact on cerebral perfusion, lung aeration, cardiovascular and respiratory parameters.
Detailed description
In patients with subarachnoid hemorrhage, the mobilization strategy has been little studied. Several studies have already evaluated the consequences of mobilization in bed. Because of the deleterious consequences of prolonged bed rest, and in line with recommendations, practices have evolved towards early out-of-bed mobilization, which has shown benefits. However, the physiological consequences of out-of-bed mobilization have not yet been assessed. The aim of this study is to measure the impact of early out-of-bed mobilization of patients admitted for SAH on neuro-cardio-pulmonary physiological parameters.
Interventions
DEVICElung ultrasound
Used to diagnose and monitor pulmonary aeration in the context of prolonged decubitus disorders (atelectasis) via the lung ultrasound score (LUS).
DEVICETranscranial Doppler
Non-invasive, bedside method of measuring cerebral blood flow.
Non-invasive, bedside method of cerebral oximetry that requires no advanced expertise.
DEVICEclinical examination
clinical examination
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Age ≥ 18 years * Aneurysmal SAH * Severity score World Federation Neurological Surgeons I to IV * Secured aneurysm * Eligible for their first early mobilization
Exclusion criteria
* Sedated patient * Disturbed alertness, coma * Unsecured aneurysm * Patients under legal protection (guardianship, curatorship, safeguard of justice)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impact on lung aeration | at T0 before initiation of out-of-bed mobilization, and 15 minutes after moving to the chair. | Lung Ultrasound Score by lung ultrasound, Ranging from 0 (normal lungs) to 36 (worst case scenario). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Impact on cerebral tissue oxygenation | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. | cerebral tissue oxygenation via NIRS |
| Impact on heart rate | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. | Heart rate |
| Impact on arterial pressure | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. | Arterial pressure |
| Impact on cerebral blood flow | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. | cerebral blood flow using average velocities on transcranial Doppler |
| Impact on neurological examination | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. | Glasgow Coma Scale score (scored between 3 and 15, 3 being the worst and 15 the best) |
| Impact on patient comfort | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. | Numerical Pain Rating Scale (scored between 0 and 10, 0 being no pain,10 the worst pain imaginable) |
| Impact on Saturation | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. | Saturation |
Countries
France
Contacts
Primary ContactAdéla FOUDHAÏLI, Physiotherapist
Backup ContactPr Benjamin Glenn CHOUSTERMAN
Outcome results
None listed