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Effects of Different Head-of-Bed Elevations and Body Positions on Intracranial Pressure and Cerebral Perfusion Pressure in Neurosurgical Patients

Altun Uğraş, Gülay; Yüksel, Serpil; Temiz, Zeynep; Eroğlu, Selin; Şirin, Keziban; Turan, Yüksel

Journal of Neuroscience Nursing: August 2018 - Volume 50 - Issue 4 - p 247–251
doi: 10.1097/JNN.0000000000000386
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ABSTRACT Purpose: The aim of this study was to evaluate the effects of different head of bed (HOB) elevations and body positions on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) and to identify safe positions for neurosurgical patients with different Glasgow Coma Scale (GCS) scores. Methods: This study with a quasi-experimental, prospective repeated measures is designed with control over the intervention consisted of 30 patients hospitalized in the neurocritical care units (NCU). Patients’ HOB was elevated (degree of 15,30,45) and the patients were at supine, left lateral and right lateral positions. ICP and CPP were recorded for each patient. Results: It was found that ICP increased and CPP decreased at supine, left and right lateral positions with different HOB elevations, which, however, did not reach statistical significance. When patients with a GCS score of 3–8 were at degree of 15 right and left lateral positions and 45 right lateral position; and when patients with a GCS score of 13–15 were positioned at degree of 15 left lateral, ICP and CPP changed significantly. Conclusion: The results of this study showed that different positions the patients’ HOB (degree of 15,30,45) led to slight insignificant changes in ICP and CPP; and these values were maintained within the ranges established by recent guidelines.

Gülay A. Uğraş, PhD, is Assistant Professor, Department of Surgical Nursing, The University of Mersin, Mersin, Turkey.

Serpil Yüksel, PhD, is Assistant Professor, Department of Surgical Nursing, The University of Necmettin Erbakan, Konya, Turkey.

Zeynep Temiz, PhD, is Assistant Professor, Department of Surgical Nursing, The University of Artvin Çoruh, Artvin, Turkey.

Selin Eroğlu, RN, is Nurse, Neurosurgery Intensive Care Unit, Cerrahpaşa Faculty of Medicine, The University of İstanbul, İstanbul, Turkey.

Keziban Sirin, RN, is Nurse, Cerrahpaşa Faculty of Medicine, Department of Neurosurgery, The University of Istanbul, İstanbul, Turkey.

Yüksel Turan, RN, is Nurse, Neurosurgery Intensive Care Unit, Cerrahpaşa Faculty of Medicine, The University of Istanbul, Istanbul, Turkey.

Questions or comments about this article may be directed to Gülay A. Uğraş, PhD, at carpediem0803@yahoo.com/gulay.altun@yahoo.com. She is an Assistant Professor, The Department of Surgical Nursing, School of Health, The University of Mersin, Mersin, Turkey.

The authors declare no conflicts of interest.

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© 2018 American Association of Neuroscience Nurses