Carilion Clinic
This study aims to reduce the recurrence rate of chronic subdural hematomas (CSDH) by manipulating the post-operative intravenous fluid use. The hypothesis relies on the relationship between osmolality and volume changes related to osmolality. We will be administering dextrose 5% in 1/4 normal saline (D5 1/4NS) post-operatively to induce brain expansion which can take up the residual CSDH space, to help reduce recurrence rate.
Chronic subdural hematoma (CSDH) is a neurological disease characterized by a collection of fluid, blood, and blood degradation matter between the arachnoid and dura mater in a well-developed membrane cavity. The presentation of this disease begins with minor head trauma and takes 4-7 weeks to become symptomatic. One of the significant problems exists with CSDH is the rate of recurrence, which currently stands at a 7-30% rate worldwide. The recurrence of a CSDH is typically defined as the presence of residual or recurrent CSDH after the first resolution, leading to additional surgical interve…
Inclusion Criteria: * Diagnosis of chronic subdural hematoma (based on imaging) * Need for surgical intervention (assessed by attending neurosurgeon based on full neurological assessment) * The procedure of choice is burr hole drainage * Cessation of anti-coagulant therapy with accompanying normal lab values in appropriate time frames respective to the drug * Tolerance of supine position Exclusion Criteria: * \<60 years old * Presence of acute hemorrhage, stroke, or parenchymal damage * Neurological deficits not accountable to mass effect * Hyponatremia or inherent electrolyte imbalances *…
D5 1/4NS is comprised of 5% dextrose in a 0.225% sodium chloride (NaCl) solution. D5 1/4NS is initially slightly hypertonic to plasma, with an osmolarity of 321 mOSm/L. As the glucose component is rapidly metabolized, 0.225% NaCl solution remains and is hypotonic to plasma at an osmolarity of 77 mOsm/L. Because of the hypotonicity of the 1/4NS, it shifts into the intracellular compartments, followed by free water, and allows for volume expansion.
Arctuva estimate
Actual pay is set by the research site.
Verify or correct the compensation shown for this listing.