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Wessell A, Kole MJ, Badjatia N, et al. High Compliance with Scheduled Nimodipine Is Associated with Better Outcome in Aneurysmal Subarachnoid Hemorrhage Patients Cotreated with Heparin Infusion. Front Neurol. 2017;8:268doi: 10.3389/fneur.2017.00268.
Wessell, A., Kole, M. J., Badjatia, N., Parikh, G., Albrecht, J. S., Schreibman, D. L., & Simard, J. M. (2017). High Compliance with Scheduled Nimodipine Is Associated with Better Outcome in Aneurysmal Subarachnoid Hemorrhage Patients Cotreated with Heparin Infusion. Frontiers in neurology, 8268. https://doi.org/10.3389/fneur.2017.00268
Wessell, Aaron, et al. "High Compliance with Scheduled Nimodipine Is Associated with Better Outcome in Aneurysmal Subarachnoid Hemorrhage Patients Cotreated with Heparin Infusion." Frontiers in neurology vol. 8 (2017): 268. doi: https://doi.org/10.3389/fneur.2017.00268
Wessell A, Kole MJ, Badjatia N, Parikh G, Albrecht JS, Schreibman DL, Simard JM. High Compliance with Scheduled Nimodipine Is Associated with Better Outcome in Aneurysmal Subarachnoid Hemorrhage Patients Cotreated with Heparin Infusion. Front Neurol. 2017 Jun 09;8:268. doi: 10.3389/fneur.2017.00268. eCollection 2017. PMID: 28649230; PMCID: PMC5465287.
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Front Neurol. 2017 Jun 09;8:268. doi: 10.3389/fneur.2017.00268. eCollection 2017.

High Compliance with Scheduled Nimodipine Is Associated with Better Outcome in Aneurysmal Subarachnoid Hemorrhage Patients Cotreated with Heparin Infusion.

Frontiers in neurology

Aaron Wessell, Matthew J Kole, Neeraj Badjatia, Gunjan Parikh, Jennifer S Albrecht, David L Schreibman, J Marc Simard

Affiliations

  1. Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, United States.
  2. Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.
  3. Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, United States.
  4. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States.
  5. Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States.
  6. Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, United States.

PMID: 28649230 PMCID: PMC5465287 DOI: 10.3389/fneur.2017.00268

Abstract

INTRODUCTION: We sought to determine whether compliance with scheduled nimodipine in subarachnoid hemorrhage patients impacted patient outcomes, with the intent of guiding future nimodipine management in patients who experience nimodipine-induced hypotension.

METHODS: We performed a retrospective analysis of 118 consecutive aneurysmal subarachnoid hemorrhage patients treated with the Maryland Low-Dose IV Heparin Infusion Protocol. Patients were categorized into three independent nimodipine compliance groups: ≥1 dose held, ≥1 dose split, and no missed or split-doses. A split-dose was defined as 30 mg of nimodipine administered every 2 h. Our primary outcome was discharge to home. Bivariate and multivariable logistic regression analyses were used to assess predictors of discharge disposition as a function of nimodipine compliance.

RESULTS: Of the 118 patients, 20 (17%) received all nimodipine doses, 6 (5%) received split-doses but never had a full dose held, and 92 (78%) had ≥1 dose held. Forty-five percent of patients were discharged to home, including 75% who received all doses, 67% who received ≥1 split-doses, and 37% with ≥1 missed doses (

CONCLUSION: In aneurysmal subarachnoid hemorrhage patients with modified Fisher scores 2 through 4 who are cotreated with a low-dose heparin infusion, full compliance with nimodipine dosing was associated with increased odds of discharge to home.

Keywords: cerebral aneurysm; cerebral vasospasm; heparin; nimodipine; subarachnoid hemorrhage; vascular disorders

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