The impact of a highly visible display of cerebral perfusion pressure on outcome in individuals with cerebral aneurysms

Heart Lung. 2008 May-Jun;37(3):227-37. doi: 10.1016/j.hrtlng.2007.05.015.

Abstract

Background: Nurses' ability to rapidly detect decreases in cerebral perfusion pressure (CPP), which may contribute to secondary brain injury, may be limited by poor visibility of CPP displays.

Objective: To evaluate the impact of a highly visible CPP display on the functional outcome in individuals with cerebral aneurysms.

Methods: Patients with cerebral aneurysms (n = 100) who underwent continuous CPP monitoring were enrolled and randomized to beds with or without the additional CPP display. Six-month outcome was assessed.

Results: Functional outcome was not significantly different between control and intervention groups after controlling for initial neurologic condition (odds ratio .904, 95% confidence interval 0.317 to 2.573). However, greater time below CPP thresholds (55 to 70 mm Hg) was significantly associated with poorer outcome (P = .005 to .010).

Conclusions: Although the enhanced CPP display was not associated with significantly better outcome, longer periods of CPP below set levels were associated with poorer outcome.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Blood Pressure
  • Brain / blood supply*
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / etiology
  • Brain Ischemia / prevention & control
  • Data Display*
  • Female
  • Glasgow Outcome Scale
  • Humans
  • Intensive Care Units
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / nursing*
  • Intracranial Pressure
  • Logistic Models
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Point-of-Care Systems*
  • Single-Blind Method
  • Subarachnoid Hemorrhage / complications
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / nursing*
  • Survival Analysis
  • Treatment Outcome