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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients admitted to intensive care | Patients admitted to intensive care for aneurysmal subarachnoid hemorrhage (SAH) and eligible for their first out-of-bed mobilization |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| lung ultrasound | Device | Used to diagnose and monitor pulmonary aeration in the context of prolonged decubitus disorders (atelectasis) via the lung ultrasound score (LUS). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Impact on lung aeration | Lung Ultrasound Score by lung ultrasound, Ranging from 0 (normal lungs) to 36 (worst case scenario). | at T0 before initiation of out-of-bed mobilization, and 15 minutes after moving to the chair. |
| Measure | Description | Time Frame |
|---|---|---|
| Impact on cerebral blood flow | cerebral blood flow using average velocities on transcranial Doppler | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. |
| Impact on cerebral tissue oxygenation |
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Inclusion Criteria:
Age ≥ 18 years
Exclusion Criteria:
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Patients admitted to intensive care for aneurysmal subarachnoid hemorrhage (SAH) and eligible for their first outof-bed mobilization
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Adéla FOUDHAÏLI, Physiotherapist | Contact | 0149956305 | adela.foudhaili@aphp.fr | |
| Pr Benjamin Glenn CHOUSTERMAN | Contact | 0149958518 | benjamin.chousterman@aphp.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Adéla FOUDHAÏLI | Paris | 75010 | France |
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| ID | Term |
|---|---|
| D013345 | Subarachnoid Hemorrhage |
| ID | Term |
|---|---|
| D020300 | Intracranial Hemorrhages |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D017585 | Ultrasonography, Doppler, Transcranial |
| D019265 | Spectroscopy, Near-Infrared |
| D010808 | Physical Examination |
| ID | Term |
|---|---|
| D004453 | Echoencephalography |
| D009485 | Neuroradiography |
| D059906 | Neuroimaging |
| D003952 | Diagnostic Imaging |
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| Transcranial Doppler | Device | Non-invasive, bedside method of measuring cerebral blood flow. |
|
| near-infrared spectroscopy (NIRS) | Device | Non-invasive, bedside method of cerebral oximetry that requires no advanced expertise. |
|
| clinical examination | Device | clinical examination |
|
cerebral tissue oxygenation via NIRS |
| At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. |
| Impact on heart rate | 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. |
| Impact on arterial pressure | 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. |
| Impact on Saturation | Saturation | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. |
| Impact on neurological examination | Glasgow Coma Scale score (scored between 3 and 15, 3 being the worst and 15 the best) | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. |
| Impact on patient comfort | Numerical Pain Rating Scale (scored between 0 and 10, 0 being "no pain",10 "the worst pain imaginable") | At T0 before initiation of out-of-bed mobilization, immediately after moving to the edge the bed, immediately after moving to the chair. |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019937 |
| Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D011859 | Radiography |
| D014463 | Ultrasonography |
| D018608 | Ultrasonography, Doppler |
| D003943 | Diagnostic Techniques, Neurological |
| D008919 | Investigative Techniques |
| D013057 | Spectrum Analysis |
| D002623 | Chemistry Techniques, Analytical |