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An observational pilot study of CSF diversion in subarachnoid haemorrhage.

Publication ,  Journal Article
Amato, A; Britz, GW; James, ML; Graffagnino, C; Zomorodi, AR; Zomorodi, ME; Olson, DM
Published in: Nurs Crit Care
2011

BACKGROUND: A primary focus of hospital treatment following admission for subarachnoid haemorrhage (SAH) is a prevention of cerebral artery vasospasm, which may result in ischaemic stroke. Intraventricular catheter (IVC) insertion to facilitate cerebral spinal fluid (CSF) drainage and intracranial pressure (ICP) monitoring may reduce the incidence or severity of vasospasm, but insufficient evidence exists from which clinicians may determine the best practice of CSF management. AIMS: The aim of this study was to provide the pilot data to explore the impact of different methods of CSF drainage on outcomes in patients with SAH. METHODS: In this non-randomized observational study, patients diagnosed with SAH who had ICP monitoring in situ were prospectively enrolled. Group assignment was determined by the method of external ventricular drainage (EVD) management prescribed by the attending physician prior to enrollment. RESULTS: The 37 subjects were disproportionately divided: open-EVD group (N = 24) and monitor-ICP group (N = 13). There were no statistically significant differences by group assignment with respect to vasospasm, length of stay (LOS), highest average ICP, total CSF drained and disability upon discharge between groups. CONCLUSIONS: Although not significant, our results show that the monitor-ICP group trended towards improved clinical outcomes. These results provide sufficient equipoise to support further research in ICP management in patients with SAH using a randomized clinical trial. RELEVANCE TO CLINICAL PRACTICE: This study provides a solid foundation for the development of a randomized trial exploring two different methods of ICP monitoring and CSF diversion during the acute phase of care following aneurysm rupture.

Duke Scholars

Published In

Nurs Crit Care

DOI

EISSN

1478-5153

Publication Date

2011

Volume

16

Issue

5

Start / End Page

252 / 260

Location

England

Related Subject Headings

  • Vasospasm, Intracranial
  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Prospective Studies
  • Pilot Projects
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Intracranial Pressure
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Amato, A., Britz, G. W., James, M. L., Graffagnino, C., Zomorodi, A. R., Zomorodi, M. E., & Olson, D. M. (2011). An observational pilot study of CSF diversion in subarachnoid haemorrhage. Nurs Crit Care, 16(5), 252–260. https://doi.org/10.1111/j.1478-5153.2010.00444.x
Amato, Anthony, Gavin W. Britz, Michael L. James, Carmelo Graffagnino, Ali R. Zomorodi, Margaret E. Zomorodi, and DaiWai M. Olson. “An observational pilot study of CSF diversion in subarachnoid haemorrhage.Nurs Crit Care 16, no. 5 (2011): 252–60. https://doi.org/10.1111/j.1478-5153.2010.00444.x.
Amato A, Britz GW, James ML, Graffagnino C, Zomorodi AR, Zomorodi ME, et al. An observational pilot study of CSF diversion in subarachnoid haemorrhage. Nurs Crit Care. 2011;16(5):252–60.
Amato, Anthony, et al. “An observational pilot study of CSF diversion in subarachnoid haemorrhage.Nurs Crit Care, vol. 16, no. 5, 2011, pp. 252–60. Pubmed, doi:10.1111/j.1478-5153.2010.00444.x.
Amato A, Britz GW, James ML, Graffagnino C, Zomorodi AR, Zomorodi ME, Olson DM. An observational pilot study of CSF diversion in subarachnoid haemorrhage. Nurs Crit Care. 2011;16(5):252–260.
Journal cover image

Published In

Nurs Crit Care

DOI

EISSN

1478-5153

Publication Date

2011

Volume

16

Issue

5

Start / End Page

252 / 260

Location

England

Related Subject Headings

  • Vasospasm, Intracranial
  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Prospective Studies
  • Pilot Projects
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Intracranial Pressure
  • Humans