What question did this study set out to answer?

To evaluate the physiological effect of enteral nimodipine on brain tissue oxygen tension in patients with severe subarachnoid hemorrhage.

October 1, 2004Journal of neurosurgery

The effect of nimodipine on cerebral oxygenation in patients with poor-grade subarachnoid hemorrhage

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Why the study?

Does nimodipine affect brain tissue PO2 in patients with poor-grade subarachnoid hemorrhage?

Population

11 patients with Hunt and Hess Grade IV or V subarachnoid hemorrhage who underwent aneurysm occlusion and…

Comparison

Nimodipine 60 mg delivered through a nasogastric… vs Baseline (pre-administration)

Design

Cohort

Follow-up

2 hours post-administration

Authors

MSMichael StiefelPiedmont HealthCare GHGregory G. HeuerChildren's Hospital of Philadelphia JAJohn M. AbrahamsRoyal Adelaide Hospital

Discussion

Member takes

Implication

May transiently lower brain oxygenation in poor-grade SAH; this Level 3 observation leaves open clinical relevance and need for prospective trials.

Key Points

To evaluate the physiological effect of enteral nimodipine on brain tissue oxygen tension in patients with severe subarachnoid hemorrhage.
Prospective physiological study of N=11 patients with Hunt and Hess Grade IV or V subarachnoid hemorrhage who underwent aneurysm occlusion and maintained stable blood pressure.
Continuous monitoring of brain tissue PO2, intracranial pressure, mean arterial blood pressure, and cerebral perfusion pressure recorded at 15-minute intervals following enteral administration of 60 mg nimodipine every 4 hours.
Nimodipine induced a significant drop in brain tissue PO2 in 64% (7/11) of patients, decreasing from a baseline of 38.4 ± 10.9 mm Hg to a nadir of 26.9 ± 7.7 mm Hg at 15 minutes (p < 0.05).
Brain tissue PO2 remained significantly suppressed at 30 minutes (27.5 ± 7.7 mm Hg, p < 0.05) and 60 minutes (29.7 ± 11.1 mm Hg, p < 0.05) before returning to baseline levels at 2 hours.
In the remaining 36% (4/11) of patients, brain PO2 remained stable with no significant increases observed, while systemic parameters including blood pressure and heart rate showed no association with oxygen decline.

Structured PICO

Does nimodipine affect brain tissue PO2 in patients with poor-grade subarachnoid hemorrhage?

Population

11 patients with Hunt and Hess Grade IV or V subarachnoid hemorrhage (SAH) who underwent aneurysm occlusion and had stable blood pressure

Intervention

Nimodipine 60 mg delivered through a nasogastric or Dobhoff tube every 4 hours

Comparator

Baseline (pre-administration)

Outcome

Brain tissue PO2surrogate

Nimodipine administration can temporarily reduce brain tissue PO2 in some patients with poor-grade subarachnoid hemorrhage.

Cite This Study

Stiefel et al. (2004) studied this question.

synapsesocial.com/papers/6a90e245097347c7becae1d4 https://doi.org/10.3171/jns.2004.101.4.0594

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Implication

May transiently lower brain oxygenation in poor-grade SAH; this Level 3 observation leaves open clinical relevance and need for prospective trials.

The effect of nimodipine on cerebral oxygenation in patients with poor-grade subarachnoid hemorrhage

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The effect of nimodipine on cerebral oxygenation in patients with poor-grade subarachnoid hemorrhage

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider