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Could Nursing Interventions Cause Secondary Brain Insult?

Year 2019, Issue: 1, 13 - 19, 01.03.2019

Abstract

As a result of increase in intracranial pressure, decrease in cerebral perfusion pressure, hypotension and decrease in cerebral blood flow secondary brain insult may occur. The main focus of treatment and nursing care in neurosurgical patients is to prevent intracranial pressure increase. But some nursing interventions can also cause secondary brain damage. Routine nursing interventions such as endotracheal suction, oral care, body bath, rotationing and repositioning of patients and clusteringof nursing interventions may cause secondary brain insult by increasing cerebral metabolism rate, decreasing cerebral perfusion pressure and affecting cerebral blood flow. This systematic review aims to provide guidance to nurses about the prevention of secondary brain insult by reviewing the nursing interventions that may cause secondary brain insult in neurosurgical patients in the light of current literature

References

  • 1. Nyholm L, Howells T, Enblad P. Predictive factors that may contribute to secondary insults with nursing interventions in adults with traumatic brain injury. J Neurosci Nurs 2017;49:49–55. [CrossRef]
  • 2. Altun Uğraş G. Kafa içi basınç artışı ve hemşirelik bakımı. İçinde: Öztekin SD, editör. Nöroşirürji Hemşireliği. İstanbul: Nobel Tıp Kitapevi; 2015. ss.29–49.
  • 3. Altun Uğraş G, Yüksel S. Factors affecting intracranial pressure and nursing interventions. Jacobs J Nurs Care 2014;1:1–5.
  • 4. Öztekin SD, Öztekin İ. Kafa Travmaları: Fiziksel Tanılama Tedavi ve Bakımda Temel İlkeler. İçinde: Öztekin SD. Nöroşirürji Hemşireliği. İstanbul: Nobel Tıp Kitapevi 2015:53–86.
  • 5. Szabo CM, Grap MJ, Munro CL, Starkweather A, Merchant RE. The effect of oral care on intracranial pressure in critically ill adults. J Neurosci Nurs 2014;46:321–9. [CrossRef]
  • 6. Nyholm L, Steffansson E, Fröjd C, Enblad P. Secondary insults related to nursing interventions in neurointensive care: a descriptive pilot study. J Neurosci Nurs 2014;46:285–91. [CrossRef]
  • 7. McNett MM, Olson DM. Evidence to guide nursing interventions for critically ill neurologically impaired patients with ICP monitoring. J Neurosci Nurs 2013;45:120–3. [CrossRef]
  • 8. Savcı C, Kaya H, Acaroğlu R, Kaya N, Bilir A, Kahraman H, Gökerler N. Nöroloji ve nöroşirürji kliniklerinde hastaların düşme riski ve alınan önlemlerin belirlenmesi. Maltepe Üniv Hemşirelik Bilim ve Sanatı Dergisi 2009;2:19–25.
  • 9. Szabo CM. The effect of oral care on intracranial pressure: a review of the literature. J Neurosci Nurs 2011;43:E1–9. [CrossRef]
  • 10. Galbiati G, Paola C. Effect of open and closed endotracheal suctioning on intracranial pressure and cerebral perfusion pressure in adult patients with severe brain injury: a literature review. J Neurosci Nurs 2015;47:239–46. [CrossRef]
  • 11. Altun Uğraş G, Aksoy G. The effects of open and closed endotracheal suctioning on intracranial pressure and cerebral perfusion pressure: a crossover, single-blind clinical trial. J Neurosci Nurs 2012;44:E1–8. [CrossRef]
  • 12. Carney N, Totten A, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017;80:6–15. [CrossRef]
  • 13. Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. J Neurotrauma 2007;24:S1–106. [CrossRef]
  • 14. Gemma M, Tommasino C, Cerri M, Giannotti A, Piazzi B, Borghi T. Intracranial effects of endotracheal suctioning in the acute phase of head injury. J Neurosurg Anesthesiol 2002;14:50–4. [CrossRef]
  • 15. Bourgault AM, Brown CA, Hains SM, Parlow JL. Effects of endotracheal tube suctioning on arterial oxygen tension and heart rate variability. Biol Res Nurs 2006;7:268–78. [CrossRef]
  • 16. Özden D, Görgülü RS. Effects of open and closed suction systems on the haemodynamic parameters in cardiac surgery patients. Nurs Crit Care 2015;20:118–25. [CrossRef]
  • 17. Thiesen RA, Dragosavac D, Roquejani AC, Falcão ALE, Araujo S, Dantas-Filho VP, et al. Influence of the respiratory physiotherapy on intracranial pressure in severe head trauma patients. Arq Neuropsiquiatr 2005;63:110–3. [CrossRef]
  • 18. Leone M, Abanese J, Viviand X, Garnier F, Bourgoin A, Barrau K, Martin C.. The effects of reminfentanil on endotracheal suctioninginduced increases in intracranial pressure in head-injured patients. Anesth Analg 2004;99:1193–8. [CrossRef]
  • 19. Chivite Fernández N, Martinez Oroz A, Marraco Bonmcompte M, Navarro García MA, Nuin ES, Gomez de Segura Nieva JL, Bermejo Fraile B. Intracranial pressure response during secretion aspiration after administration of a muscle relaxant. Enferm Intensiva 2004;16:143–52.
  • 20. Bilotta F, Branca G, Lam A, Cuzzone V, Doronzio A, Rosa G.. Endotracheal lidocaine in preventing endotracheal suctioninginduced changes in cerebral hemodynamics in patients with severe head trauma. Neurocrit Care 2008;8:241–6. [CrossRef]
  • 21. Hickey JV, Olson DM, Turner DA. Intracranial pressure waveform analysis during rest and suctioning. Biol Res Nurs 2009;11:174–86. [CrossRef]
  • 22. Gholamzadeh S, Javadi M. Effect of endotracheal suctioning on intracranial pressure in severe head-injured patients. Crit Care 2009;13:1–2. [CrossRef]
  • 23. Nemer S, Barbas C, Caldeira J, Guimaraes B, Azeredo L, Gago R, Souza PCP. Evaluation of maximal inspiratory pressure, tracheal airway occlusion pressure, and its ration in the weaning outcome. Crit Care 2009;24:441–6. [CrossRef]
  • 24. Cerqueira-Neto ML, Moura ÀV, Scola RH, Aquim EE, Rea-Neto À, Oliveira MC, Cerqueira TCF. The effect of breath physiotherapeutic maneuvers on cerebral hemodynamics. Arq Neuropsiquiatr 2010;68:567–72. [CrossRef]
  • 25. Mathieu A, Guillon A, Leyre S, Martin F, Fusciardi J, Laffon M. Aerosolized lidocaine during invasive mechanical ventilation: invitro characterization and clinical efficiency to prevent systemic and cerebral hemodynamic changes induced by endotracheal suctioning in head-injured patients. J Neurosurg Anesthesiol 2013;25:8–15. [CrossRef]
  • 26. Ledwith MB, Bloom S, Maloney-Wilensky E, Coyle B, Polomano RC, Le Roux PD. Effect of body position on cerebral oxygenation and physiologic parameters in patients with acute neurological conditions. J Neurosci Nurs 2010;42:280–7. [CrossRef]
  • 27. Weaver DL, Bradford JL. Neurologic System Function, Assessment and Therapeutic Measures. In: Williams LS, Hooper PD, editors. Understanding Medical Surgical Nursing, 5th ed. Philadelphia: FA Davis Company; 2015. pp.1095–210.
  • 28. Hickey JV, Olson DM. Intracranial hipertension: theory and management of increased intracranial pressure. In: Hickey JV, editor. The Clinical Practice of Neurological and Neurosurgical Nursing, 6th ed. USA: Wolters Kluwer Health, Lippincott Williams & Wilkins; 2009. pp.270–307.
  • 29. Barker E. Intracranial pressure and monitoring. In: Barker E, editor. Neuroscience Nursing, a Spectrum of Care, 3rd ed. St. Louis: Mosby Elsevier; 2008. pp.305–36.
  • 30. Ng I, Lim J, Wong HB. Effects of head posture on cerebral hemodynamics: its influences on intracranial pressure, cerebral perfusion pressure, and cerebral oxygenation. Neurosurgery 2004;54:593–8. [CrossRef]
  • 31. Palazón JH, Asensi PD, López SB, Bautista FP, Candel AG. Effect of head elevation on intracranial pressure, cerebral perfusion pressure and regional cerebral oxygen saturation in patients with cerebral hemorrhage. Rev Esp Anestesiol Reanim 2008;55:289–93.
  • 32. Kose G, Hatipoglu S. Effect of headand body positioning on cerebral blood flow velocity in patients who underwent cranial surgery. J Clin Nurs 2012;21:1859–67. [CrossRef]
  • 33. Jiang Y, Ye Z, You C, Hu X, Liu Y, Li H, et al. Systematic review of decreased intracranial pressure with optimal head elevation in post craniotomy patients: a meta-analysis. J Adv Nurs 2015;71;10:2237– 46. [CrossRef]
  • 34. Yüksel S, Altun Uğraş G. Nöroşirürji hastalarında ağız bakımı kafa içi basıncı etkiler mi? Türk Nöroşirürji Derg 2015;Ek sayı:494.
  • 35. Prendergast V, Hallberg IR, Jahnke H, Kleiman C, Hagell P. Oral health, ventilator-associated pneumonia, and intracranial pressure in intubated patients in a neuroscience intensive care unit. Am J Crit Care 2009;18:368–76. [CrossRef]
  • 36. Prendergast V, Hagell P, Hallberg IR. Electric versus manual tooth brushing among neuroscience ICU patients: is it safe? Neurocrit Care 2011;14:281–6. [CrossRef]

Hemşirelik Girişimleri İkincil Beyin Hasarına Neden Olabilir mi?

Year 2019, Issue: 1, 13 - 19, 01.03.2019

Abstract

İkincil beyin hasarı; kafa içi basınç artışı, serebral perfüzyon basıncında azalma, hipotansiyon ve serebral kan akımında azalma sonucu meydana gelmektedir. Nöroşirürji hastalarında tedavi ve hemşirelik bakımının odak noktası kafa içi basınç artışını önlemektir. Ancak bazı hemşirelik girişimleri de ikincil beyin hasarına neden olabilmektedir. Endotrakeal aspirasyon, ağız bakımı, vücut banyosu, hastayı döndürme ya da yeniden pozisyon verme ve hemşirelik girişimlerinin bir araya toplanması gibi rutin uygulanan hemşirelik girişimleri, serebral metabolizma hızını arttırdığı, serebral perfüzyon basıncını azalttığı ve serebral kan akımını etkileyerek, ikincil beyin hasarına yol açabilmektedir. Bu sistematik derlemede, nöroşirürji hastalarında ikincil beyin hasarına neden olabilecek hemşirelik girişimlerini güncel literatür eşliğinde irdelemek ve hemşirelere ikincil beyin hasarının önlenmesine yönelik rehberlik edecek bilgiler sunmak amaçlandı

References

  • 1. Nyholm L, Howells T, Enblad P. Predictive factors that may contribute to secondary insults with nursing interventions in adults with traumatic brain injury. J Neurosci Nurs 2017;49:49–55. [CrossRef]
  • 2. Altun Uğraş G. Kafa içi basınç artışı ve hemşirelik bakımı. İçinde: Öztekin SD, editör. Nöroşirürji Hemşireliği. İstanbul: Nobel Tıp Kitapevi; 2015. ss.29–49.
  • 3. Altun Uğraş G, Yüksel S. Factors affecting intracranial pressure and nursing interventions. Jacobs J Nurs Care 2014;1:1–5.
  • 4. Öztekin SD, Öztekin İ. Kafa Travmaları: Fiziksel Tanılama Tedavi ve Bakımda Temel İlkeler. İçinde: Öztekin SD. Nöroşirürji Hemşireliği. İstanbul: Nobel Tıp Kitapevi 2015:53–86.
  • 5. Szabo CM, Grap MJ, Munro CL, Starkweather A, Merchant RE. The effect of oral care on intracranial pressure in critically ill adults. J Neurosci Nurs 2014;46:321–9. [CrossRef]
  • 6. Nyholm L, Steffansson E, Fröjd C, Enblad P. Secondary insults related to nursing interventions in neurointensive care: a descriptive pilot study. J Neurosci Nurs 2014;46:285–91. [CrossRef]
  • 7. McNett MM, Olson DM. Evidence to guide nursing interventions for critically ill neurologically impaired patients with ICP monitoring. J Neurosci Nurs 2013;45:120–3. [CrossRef]
  • 8. Savcı C, Kaya H, Acaroğlu R, Kaya N, Bilir A, Kahraman H, Gökerler N. Nöroloji ve nöroşirürji kliniklerinde hastaların düşme riski ve alınan önlemlerin belirlenmesi. Maltepe Üniv Hemşirelik Bilim ve Sanatı Dergisi 2009;2:19–25.
  • 9. Szabo CM. The effect of oral care on intracranial pressure: a review of the literature. J Neurosci Nurs 2011;43:E1–9. [CrossRef]
  • 10. Galbiati G, Paola C. Effect of open and closed endotracheal suctioning on intracranial pressure and cerebral perfusion pressure in adult patients with severe brain injury: a literature review. J Neurosci Nurs 2015;47:239–46. [CrossRef]
  • 11. Altun Uğraş G, Aksoy G. The effects of open and closed endotracheal suctioning on intracranial pressure and cerebral perfusion pressure: a crossover, single-blind clinical trial. J Neurosci Nurs 2012;44:E1–8. [CrossRef]
  • 12. Carney N, Totten A, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017;80:6–15. [CrossRef]
  • 13. Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. J Neurotrauma 2007;24:S1–106. [CrossRef]
  • 14. Gemma M, Tommasino C, Cerri M, Giannotti A, Piazzi B, Borghi T. Intracranial effects of endotracheal suctioning in the acute phase of head injury. J Neurosurg Anesthesiol 2002;14:50–4. [CrossRef]
  • 15. Bourgault AM, Brown CA, Hains SM, Parlow JL. Effects of endotracheal tube suctioning on arterial oxygen tension and heart rate variability. Biol Res Nurs 2006;7:268–78. [CrossRef]
  • 16. Özden D, Görgülü RS. Effects of open and closed suction systems on the haemodynamic parameters in cardiac surgery patients. Nurs Crit Care 2015;20:118–25. [CrossRef]
  • 17. Thiesen RA, Dragosavac D, Roquejani AC, Falcão ALE, Araujo S, Dantas-Filho VP, et al. Influence of the respiratory physiotherapy on intracranial pressure in severe head trauma patients. Arq Neuropsiquiatr 2005;63:110–3. [CrossRef]
  • 18. Leone M, Abanese J, Viviand X, Garnier F, Bourgoin A, Barrau K, Martin C.. The effects of reminfentanil on endotracheal suctioninginduced increases in intracranial pressure in head-injured patients. Anesth Analg 2004;99:1193–8. [CrossRef]
  • 19. Chivite Fernández N, Martinez Oroz A, Marraco Bonmcompte M, Navarro García MA, Nuin ES, Gomez de Segura Nieva JL, Bermejo Fraile B. Intracranial pressure response during secretion aspiration after administration of a muscle relaxant. Enferm Intensiva 2004;16:143–52.
  • 20. Bilotta F, Branca G, Lam A, Cuzzone V, Doronzio A, Rosa G.. Endotracheal lidocaine in preventing endotracheal suctioninginduced changes in cerebral hemodynamics in patients with severe head trauma. Neurocrit Care 2008;8:241–6. [CrossRef]
  • 21. Hickey JV, Olson DM, Turner DA. Intracranial pressure waveform analysis during rest and suctioning. Biol Res Nurs 2009;11:174–86. [CrossRef]
  • 22. Gholamzadeh S, Javadi M. Effect of endotracheal suctioning on intracranial pressure in severe head-injured patients. Crit Care 2009;13:1–2. [CrossRef]
  • 23. Nemer S, Barbas C, Caldeira J, Guimaraes B, Azeredo L, Gago R, Souza PCP. Evaluation of maximal inspiratory pressure, tracheal airway occlusion pressure, and its ration in the weaning outcome. Crit Care 2009;24:441–6. [CrossRef]
  • 24. Cerqueira-Neto ML, Moura ÀV, Scola RH, Aquim EE, Rea-Neto À, Oliveira MC, Cerqueira TCF. The effect of breath physiotherapeutic maneuvers on cerebral hemodynamics. Arq Neuropsiquiatr 2010;68:567–72. [CrossRef]
  • 25. Mathieu A, Guillon A, Leyre S, Martin F, Fusciardi J, Laffon M. Aerosolized lidocaine during invasive mechanical ventilation: invitro characterization and clinical efficiency to prevent systemic and cerebral hemodynamic changes induced by endotracheal suctioning in head-injured patients. J Neurosurg Anesthesiol 2013;25:8–15. [CrossRef]
  • 26. Ledwith MB, Bloom S, Maloney-Wilensky E, Coyle B, Polomano RC, Le Roux PD. Effect of body position on cerebral oxygenation and physiologic parameters in patients with acute neurological conditions. J Neurosci Nurs 2010;42:280–7. [CrossRef]
  • 27. Weaver DL, Bradford JL. Neurologic System Function, Assessment and Therapeutic Measures. In: Williams LS, Hooper PD, editors. Understanding Medical Surgical Nursing, 5th ed. Philadelphia: FA Davis Company; 2015. pp.1095–210.
  • 28. Hickey JV, Olson DM. Intracranial hipertension: theory and management of increased intracranial pressure. In: Hickey JV, editor. The Clinical Practice of Neurological and Neurosurgical Nursing, 6th ed. USA: Wolters Kluwer Health, Lippincott Williams & Wilkins; 2009. pp.270–307.
  • 29. Barker E. Intracranial pressure and monitoring. In: Barker E, editor. Neuroscience Nursing, a Spectrum of Care, 3rd ed. St. Louis: Mosby Elsevier; 2008. pp.305–36.
  • 30. Ng I, Lim J, Wong HB. Effects of head posture on cerebral hemodynamics: its influences on intracranial pressure, cerebral perfusion pressure, and cerebral oxygenation. Neurosurgery 2004;54:593–8. [CrossRef]
  • 31. Palazón JH, Asensi PD, López SB, Bautista FP, Candel AG. Effect of head elevation on intracranial pressure, cerebral perfusion pressure and regional cerebral oxygen saturation in patients with cerebral hemorrhage. Rev Esp Anestesiol Reanim 2008;55:289–93.
  • 32. Kose G, Hatipoglu S. Effect of headand body positioning on cerebral blood flow velocity in patients who underwent cranial surgery. J Clin Nurs 2012;21:1859–67. [CrossRef]
  • 33. Jiang Y, Ye Z, You C, Hu X, Liu Y, Li H, et al. Systematic review of decreased intracranial pressure with optimal head elevation in post craniotomy patients: a meta-analysis. J Adv Nurs 2015;71;10:2237– 46. [CrossRef]
  • 34. Yüksel S, Altun Uğraş G. Nöroşirürji hastalarında ağız bakımı kafa içi basıncı etkiler mi? Türk Nöroşirürji Derg 2015;Ek sayı:494.
  • 35. Prendergast V, Hallberg IR, Jahnke H, Kleiman C, Hagell P. Oral health, ventilator-associated pneumonia, and intracranial pressure in intubated patients in a neuroscience intensive care unit. Am J Crit Care 2009;18:368–76. [CrossRef]
  • 36. Prendergast V, Hagell P, Hallberg IR. Electric versus manual tooth brushing among neuroscience ICU patients: is it safe? Neurocrit Care 2011;14:281–6. [CrossRef]
There are 36 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

Gülay Altun Uğraş

Canan Kanat

Publication Date March 1, 2019
Published in Issue Year 2019Issue: 1

Cite

EndNote Uğraş GA, Kanat C (March 1, 2019) Hemşirelik Girişimleri İkincil Beyin Hasarına Neden Olabilir mi?. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 1 13–19.