Effects of Head-of-Bed on Intracranial Pressure

Launched by MILTON S. HERSHEY MEDICAL CENTER · Oct 31, 2022

Keywords

ClinConnect Summary

This clinical trial is looking at how changing the position of a patient’s head affects the pressure inside the skull for those who have experienced a specific type of brain bleed called subarachnoid hemorrhage. By studying this, researchers hope to better understand how to manage intracranial pressure, which can be crucial for recovery.

To participate in this trial, patients must be at least 18 years old and have been diagnosed with subarachnoid hemorrhage through imaging tests like a CT scan or MRI. Additionally, they need to have a device that monitors the pressure inside their skull and continuous monitoring of their blood pressure. However, certain patients will not be eligible—for example, those who are very unstable or have serious heart or liver conditions. Participants who qualify can expect to be closely monitored during the study, and their positions will be adjusted to see how it affects their intracranial pressure.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients with subarachnoid hemorrhage confirmed by CT scan, MRI, or cerebral angiogram
• • Age ≥ 18 years old
• • Patients with intracranial pressure monitoring device
• • Patients with continuous arterial blood pressure monitoring
• • The subject or legally authorized representative must be available and able to consent
• Exclusion Criteria:
• • Intubated patients who are prone
• • Patients with left ventricular ejection fraction \<20% as evidenced by echocardiogram previously documented at any time in the electronic medical record
• • Patients with a diagnosis of pulmonary hypertension
• • Patients with a diagnosis of cirrhosis and/or evidence of liver failure. Evidence of liver failure will be assessed by the presence of ascites, edema, abnormal lab values including low albumin, elevated PTT, elevated PT, elevated INR, or elevated bilirubin without another etiology, or MELD score \>8.
• • Patients who are clinically unstable defined as those who are unable to lie flat for 30 minutes for any reason, patients on more than one continuous IV medications to increase blood pressure, or patients who are actively undergoing resuscitation.