Effect of different head elevation angle on intracranial pressure and cerebral blood flow of patients with hypertensive cerebral hemorrhage in a resting state / 中国实用护理杂志

ABSTRACT

Objective:To explore the effect of different head elevation angle on intracranial pressure and cerebral blood flow of patients with hypertensive cerebral hemorrhage in a resting state, to provide scientific basis for nursing development.Methods:A total of 72 hypertensive cerebral hemorrhage patients were selected as research subject, at the resting state, head elevation was raised up with 0°, 5°, 10°, 15°, 20°, 25°, 30° in the supine position with 5 minutes interval between different positions. The levels of intracranial pressure, cerebral perfusion pressure, regional oxygen saturation, blood pressure, heart rate, pulse oxygen saturation were recorded.Results:With head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the levels of intracranial pressure were (12.39±3.32), (10.64±3.19), (9.84±2.58), (9.09±1.76), (8.33±2.51), (7.13±1.81), (6.81±1.67) mmHg(1 mmHg=0.133 kPa); mean arterial pressure were (106.06±10.17), (104.45±10.77), (105.87±6.73), (106.82±10.36), (105.78±10.27), (106.77±6.15), (100.30±10.92) mmHg; cerebral perfusion pressure were (93.67±10.36), (93.82±10.81), (96.03±7.26), (97.73±10.63), (97.45±10.38), (99.65±6.62), (93.49±10.99) mmHg; regional oxygen saturation were (65.91±6.70)%, (66.89±6.52)%, (67.12±8.04)%, (69.33±13.26)%, (69.31±8.47)%, (68.94±9.82)%, (66.12±6.78)%. Intracranial pressure was increased gradually with head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the difference was statistically significant ( F value was 45.380, P<0.01). Mean arterial pressure was significantly decreased at 30° head elevation compared to the 0°, 5°, 10°, 15°, 20°, 25° head elevation ( t values were 2.331-2.997, P<0.05). Cerebral perfusion pressure and regional oxygen saturation showed an increased trend, however, those index was decreased at 30° head elevation, the levels of cerebral perfusion pressure and regional oxygen saturation was significantly increased at 15°, 20°, 25° head elevation compared to the 0° and 30° head elevation ( t values were 2.554-3.331 and 2.378-3.091, P<0.05). However, there was no significant difference between 0°, 5°, 10°, 15°, 20°, 25°, 30° head elevation in systolic pressure, diastolic pressure, heart rate, pulse oxygen saturation ( P>0.05). Conclusions:15°-25° head elevation is a relatively appropriate position in patients with hypertensive cerebral hemorrhage.