Critical Care Management of Patients Following Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference

Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack o...

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Veröffentlicht in:Neurocritical care Jg. 15; H. 2; S. 211 - 240
Hauptverfasser: Diringer, Michael N., Bleck, Thomas P., Claude Hemphill, J., Menon, David, Shutter, Lori, Vespa, Paul, Bruder, Nicolas, Connolly, E. Sander, Citerio, Giuseppe, Gress, Daryl, Hänggi, Daniel, Hoh, Brian L., Lanzino, Giuseppe, Le Roux, Peter, Rabinstein, Alejandro, Schmutzhard, Erich, Stocchetti, Nino, Suarez, Jose I., Treggiari, Miriam, Tseng, Ming-Yuan, Vergouwen, Mervyn D. I., Wolf, Stefan, Zipfel, Gregory
Format: Journal Article
Sprache:Englisch
Veröffentlicht: New York Humana Press Inc 01.10.2011
Springer Nature B.V
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ISSN:1541-6933, 1556-0961, 1556-0961
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Abstract Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack of high quality data has led to numerous approaches to management and limited guidance on choosing among them. Existing guidelines emphasize risk factors, prevention, natural history, and prevention of rebleeding, but provide limited discussion of the complex critical care issues involved in the care of SAH patients. The Neurocritical Care Society organized an international, multidisciplinary consensus conference on the critical care management of SAH to address this need. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. A jury of four experienced neurointensivists was selected for their experience in clinical investigations and development of practice guidelines. Recommendations were developed based on literature review using the GRADE system, discussion integrating the literature with the collective experience of the participants and critical review by an impartial jury. Recommendations were developed using the GRADE system. Emphasis was placed on the principle that recommendations should be based not only on the quality of the data but also tradeoffs and translation into practice. Strong consideration was given to providing guidance and recommendations for all issues faced in the daily management of SAH patients, even in the absence of high quality data.
AbstractList Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack of high quality data has led to numerous approaches to management and limited guidance on choosing among them. Existing guidelines emphasize risk factors, prevention, natural history, and prevention of rebleeding, but provide limited discussion of the complex critical care issues involved in the care of SAH patients. The Neurocritical Care Society organized an international, multidisciplinary consensus conference on the critical care management of SAH to address this need. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. A jury of four experienced neurointensivists was selected for their experience in clinical investigations and development of practice guidelines. Recommendations were developed based on literature review using the GRADE system, discussion integrating the literature with the collective experience of the participants and critical review by an impartial jury. Recommendations were developed using the GRADE system. Emphasis was placed on the principle that recommendations should be based not only on the quality of the data but also tradeoffs and translation into practice. Strong consideration was given to providing guidance and recommendations for all issues faced in the daily management of SAH patients, even in the absence of high quality data.
Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack of high quality data has led to numerous approaches to management and limited guidance on choosing among them. Existing guidelines emphasize risk factors, prevention, natural history, and prevention of rebleeding, but provide limited discussion of the complex critical care issues involved in the care of SAH patients. The Neurocritical Care Society organized an international, multidisciplinary consensus conference on the critical care management of SAH to address this need. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. A jury of four experienced neurointensivists was selected for their experience in clinical investigations and development of practice guidelines. Recommendations were developed based on literature review using the GRADE system, discussion integrating the literature with the collective experience of the participants and critical review by an impartial jury. Recommendations were developed using the GRADE system. Emphasis was placed on the principle that recommendations should be based not only on the quality of the data but also tradeoffs and translation into practice. Strong consideration was given to providing guidance and recommendations for all issues faced in the daily management of SAH patients, even in the absence of high quality data.Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack of high quality data has led to numerous approaches to management and limited guidance on choosing among them. Existing guidelines emphasize risk factors, prevention, natural history, and prevention of rebleeding, but provide limited discussion of the complex critical care issues involved in the care of SAH patients. The Neurocritical Care Society organized an international, multidisciplinary consensus conference on the critical care management of SAH to address this need. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. A jury of four experienced neurointensivists was selected for their experience in clinical investigations and development of practice guidelines. Recommendations were developed based on literature review using the GRADE system, discussion integrating the literature with the collective experience of the participants and critical review by an impartial jury. Recommendations were developed using the GRADE system. Emphasis was placed on the principle that recommendations should be based not only on the quality of the data but also tradeoffs and translation into practice. Strong consideration was given to providing guidance and recommendations for all issues faced in the daily management of SAH patients, even in the absence of high quality data.
ArticleNumber 211
Author Bleck, Thomas P.
Vergouwen, Mervyn D. I.
Suarez, Jose I.
Wolf, Stefan
Gress, Daryl
Connolly, E. Sander
Hoh, Brian L.
Hänggi, Daniel
Diringer, Michael N.
Shutter, Lori
Menon, David
Schmutzhard, Erich
Stocchetti, Nino
Treggiari, Miriam
Vespa, Paul
Claude Hemphill, J.
Tseng, Ming-Yuan
Bruder, Nicolas
Citerio, Giuseppe
Lanzino, Giuseppe
Le Roux, Peter
Zipfel, Gregory
Rabinstein, Alejandro
Author_xml – sequence: 1
  givenname: Michael N.
  surname: Diringer
  fullname: Diringer, Michael N.
  email: diringerm@neuro.wustl.edu
  organization: Neurology/Neurosurgery Intensive Care Unit, Washington University
– sequence: 2
  givenname: Thomas P.
  surname: Bleck
  fullname: Bleck, Thomas P.
  organization: Rush Medical College
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  surname: Claude Hemphill
  fullname: Claude Hemphill, J.
  organization: University of California at San Francisco
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  givenname: David
  surname: Menon
  fullname: Menon, David
  organization: University of Cambridge
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  fullname: Shutter, Lori
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  organization: Université de la Méditerranée
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  surname: Connolly
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  organization: Columbia University
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  organization: San Gerardo Hospital
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  surname: Gress
  fullname: Gress, Daryl
  organization: University of Virginia
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  surname: Hänggi
  fullname: Hänggi, Daniel
  organization: Heinrich-Heine University
– sequence: 12
  givenname: Brian L.
  surname: Hoh
  fullname: Hoh, Brian L.
  organization: University of Florida
– sequence: 13
  givenname: Giuseppe
  surname: Lanzino
  fullname: Lanzino, Giuseppe
  organization: Mayo Clinic
– sequence: 14
  givenname: Peter
  surname: Le Roux
  fullname: Le Roux, Peter
  organization: University of Pennsylvania
– sequence: 15
  givenname: Alejandro
  surname: Rabinstein
  fullname: Rabinstein, Alejandro
  organization: Mayo Clinic
– sequence: 16
  givenname: Erich
  surname: Schmutzhard
  fullname: Schmutzhard, Erich
  organization: University Hospital Innsbruck
– sequence: 17
  givenname: Nino
  surname: Stocchetti
  fullname: Stocchetti, Nino
  organization: Fondazione IRCCS Cà Granda–Ospedale Policlinico, Milan University
– sequence: 18
  givenname: Jose I.
  surname: Suarez
  fullname: Suarez, Jose I.
  organization: Baylor College of Medicine
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  givenname: Miriam
  surname: Treggiari
  fullname: Treggiari, Miriam
  organization: University of Washington
– sequence: 20
  givenname: Ming-Yuan
  surname: Tseng
  fullname: Tseng, Ming-Yuan
  organization: Nottingham University Hospitals
– sequence: 21
  givenname: Mervyn D. I.
  surname: Vergouwen
  fullname: Vergouwen, Mervyn D. I.
  organization: University of Utrecht
– sequence: 22
  givenname: Stefan
  surname: Wolf
  fullname: Wolf, Stefan
  organization: Freie Universität Berlin
– sequence: 23
  givenname: Gregory
  surname: Zipfel
  fullname: Zipfel, Gregory
  organization: Washington University
BackLink https://www.ncbi.nlm.nih.gov/pubmed/21773873$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Contributor Hemphill, J Claude
Bleck, Thomas P
Suarez, Jose I
Zipfel, Gregory J
Diringer, Michael N
Hoh, Brian L
Connolly, E Sander
Gress, Daryl
Hänggi, Daniel
Wolf, Stephan
Shutter, Lori
Menon, David
Vergouwen, Mervyn D I
Schmutzhard, Erich
Stocchetti, Nino
Treggiari, Miriam
Vespa, Paul
Tseng, Ming-Yuan
Bruder, Nicolas
Citerio, Giuseppe
Lanzino, Giuseppe
Le Roux, Peter
Rabinstein, Alejandro
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Copyright Springer Science+Business Media, LLC 2011
Springer Science+Business Media, LLC 2011.
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IsPeerReviewed true
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Issue 2
Keywords Anticonvulsants
Hyponatremia
Subarachnoid hemorrhage
Endovascular
Aneurysm
Critical care
Vasospasm
Fever
Language English
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PublicationTitle Neurocritical care
PublicationTitleAbbrev Neurocrit Care
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Publisher Humana Press Inc
Springer Nature B.V
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Snippet Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact...
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StartPage 211
SubjectTerms Acute Disease
Aneurysms
Blood pressure
Case reports
Catheters
Critical care
Critical Care - standards
Critical Care Medicine
Hemorrhage
Humans
Incidence
Intensive
Internal Medicine
Ischemia
Medical imaging
Medicine
Medicine & Public Health
Neurology
Review
Secondary Prevention
Stroke
Subarachnoid Hemorrhage - mortality
Subarachnoid Hemorrhage - therapy
Vasospasm, Intracranial - mortality
Vasospasm, Intracranial - therapy
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Title Critical Care Management of Patients Following Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference
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