Does Intra-ICU Initiation of Guided Mindfulness Meditation Decrease Anxiety and Depression in SAH?: A Unique Methodology for the Neurocritical Care Setting (P5.069)

Objective: We hypothesize that intra-ICU initiation of guided mindfulness meditation is feasible and will help prevent the development of anxiety and depression in good grade SAH patients.

Background: Aneurysmal Subarachnoid Hemorrhage (SAH) has a case fatality rate of about 20%. Of all SAH patients, 40% are “good grade” defined as Hunt-Hess 1–2 with normal mental status whereas 60% are poor grade defined as Hunt-Hess grades 3–5 with changes in level of consciousness. Even among patients who make a good neurological recovery, moderate to severe anxiety and depression affect approximately one third. Non-pharmacological interventions like mindfulness meditation have proven efficacy in reducing symptoms from anxiety and depression in the outpatient psychiatric settings and oncologic settings. Mindfulness meditation as a non-pharmacological, inexpensive and safe intervention has not been studied for patients in the ICU setting. Design/Methods: Patients ≥ 18 with good grade SAH defined as Hunt-Hess score 1–2 will be included. SAH will be confirmed by CT scan or by finding of xanthocromia on cerebrospinal fluid. Patients with SAH due to trauma, ruptured arteriovenous formation or other secondary causes or who are admitted >14 days after onset will be excluded. Non English speaking patients, or those with a confounding cognitive deficit will not be eligible. Patients will be randomized into Intervention arm (daily guided mindfulness meditation; n= 20) or Control arm (daily session of supervised TV watching; n=20). The EQ5D-5L, State Trait Anxiety Inventory (STAI) and modified Rankin score (mRS), will be collected at day 14 and 3 months. Cortisol levels will be collected at day 0, 5, 7 and 10. A total of 40 patients will be enrolled.

Results: N/A

Conclusions: Based on existing literature we believe that this study is feasible. It will provide pilot data for a well powered multi centered RCT to understand whether mindfulness meditation can improve behavioral outcomes in SAH patients. Disclosure: Dr. Wheelwright has nothing to disclose. Dr. Dangayach has nothing to disclose. Dr. Griffiths has nothing to disclose. Dr. Gordon has nothing to disclose. Dr. Bederson has nothing to disclose. Dr. Kellner has nothing to disclose. Dr. O9Phelan has nothing to disclose. Dr. Mayer has received personal compensation for activities with Bard Medical.