NCT05604404

Effects of Head-of-Bed on Intracranial Pressure

Response of Intracranial Pressure Based on Head-of-Bed Positioning in Aneurysmal Subarachnoid Hemorrhage

• Status: Withdrawn
• Phase: N/A
• Study type: Interventional
• Enrollment: 0 (actual)
• Sponsor: Milton S. Hershey Medical Center · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this study is to evaluate how pressure inside the skull responds to position changes in patients with brain bleeds.

Detailed description

The optimal positioning of the head-of-bed (HOB) has remained controversial in the neurosurgical field. Very limited data exists outlining the effects of HOB positioning in subarachnoid hemorrhage (SAH) patients. One study by Schulz-Stubner and Thiex assess the effects of HOB positioning in SAH and traumatic brain injury (TBI) patients. While this study offers some valuable insight into the changes in cerebral hemodynamics seen when the HOB changes, it congregates data from two very different pathologies. This could potentially misrepresent the true effects patients experience. A study by Kung et al. assesses cerebral blood flow dynamics and HOB changes in the setting of SAH but does not evaluate the effects on intracranial pressure (ICP) (Kung, et al., 2013). There appear to be no studies which evaluate the effect of HOB positioning on ICP in patients with SAH. No current data exists to determine if dependent leg positioning would help to further lower ICP. Theoretically, placing a patient's legs in a dependent position would lead to increased venous pooling of blood in the legs which might translate to lower ICP.

Conditions

• Subarachnoid Hemorrhage, Aneurysmal

Interventions

Type	Name	Description
OTHER	Supine	The patient will be positioned supine with head-of-bed at zero degrees.
OTHER	Semi-Recumbent	The patient will be placed in a semi-recumbent position with head-of-bed at thirty degrees.
OTHER	Semi-Recumbent with Legs Flexed	The patient will be placed in a semi- recumbent position with head-of-bed at thirty degrees and legs flexed.

Timeline

• Start date: 2023-04-24
• Primary completion: 2026-04-13
• Completion: 2026-04-13
• First posted: 2022-11-03
• Last updated: 2026-04-16

Locations

1 site across 1 country: United States