How Does Interventions Performed in the ICU Modify Physiological Variables in Neurocritical Patients?

Background: Neurocritical care (NCC) patients are cared for in many ways, day and night. This care includes interventions aimed to benefit the patient, such as bed-bathing, suctioning of respiratory secretions and repositioning in bed. Several researchers have suggested some a relationship between the interventions that are performed for NCC patients with cerebrovascular disease (CVD) isquemic and hemorrhagic and traumatic brain injury (TBI) and the occurrence of clinical events that may contribute to secondary brain injury (SBI) like increase or decrease of blood pressure, intracranial pressure, cerebral perfusion pressure and heart rate.

Objective: To determine the magnitude of changes in physiological variables during three intervention performed by the healthcare team to patients with CVD or TBI in the NCC of two hospitals in Barranquilla, Colombia.

Design: Longitudinal observational study of 70 CVD/TBI patients during bed-bathing, suctioning of respiratory secretions and mobility interventions are being analyzed; measures of frequency, percentage and central tendency will be used. The patient baseline data collected included age, sex, Antecedents, primary diagnosis severity (Apache II), and admission GCS. Physiological variables included systolic blood pressure (SBP), diastolic blood pressure (DBP), Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and oxygen saturation (SatO2). Measures of frequency, percentage and central tendency are being used. The standard deviation (SD) of the physiological variables establish a reference value to estimate the general variation during the intervention in each of the times in which they are being measured, T1: start of the intervention, T2: at the end of the intervention, T3: 5 minutes after the intervention ends and T4: 10 minutes after the intervention ends. Understanding that more dispersed the distribution of data (physiological variables in each of the times), greater the standard deviation will be.

Results: To date, the study has enrolled 21 patients. This abstract will present ongoing data for the change of the physiological variables SBP, DBP, MAP, HR, RR, and SatO2 between the measures in the times 1, 2, 3, and 4 of the interventions.