Nimodipine administration routes’ role on Aneurysmal Subarachnoid Hemorrhage outcomes - A retrospective cohort study

Resumo

Aim of the study: To evaluate the role Nimodipine administration route (oral or feeding
tube) in the outcome of vasospasm (at 7 and 21 days) in patients hospitalized with
aneurysmal subarachnoid hemorrhage (SAH). Methods: The study has a retrospective
cohort design, with data collected in a tertiary teaching hospital in Porto Alegre, Brazil.
The period analyzed was between January 2019 and January 2023. Patients over 18
years old, diagnosed with SAH and who underwent at least 7 days of hospitalized ni
modipine treatment were included. Results: A total of 121 patients were included: 59
received nimodipine orally and 62 via nasoenteral tube. Nimodipine nasoenteral tube
use was related to an increase in the regression-adjusted risk of vasospasm in 7 days
(RR=2.35; 95% CI: 1.01 - 5.46) and in 21 days (RR=2.40; 95% CI: 1.05 - 5.46).
Conclusions: This is the first study in the Brazilian (or even Latin American) context, in
which the impact of the nasoenteral route of administration of nimodipine on the outco
mes of vasospasm in patients with SAH. The findings suggest that the use of Nimodipine
via nasoenteral tube in these patients may be associated with an increased risk of va
sospasm outcome, both at 7 and 21 days of treatment. Therefore, the results should be
considered in clinical practice for SAH and demonstrate the need for further studies to
correlate pharmacokinetics and clinical outcomes.