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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Bibliographic Details
Published in:Neurocritical care Vol. 15; no. 2; pp. 211 - 240
Main Authors: 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
Language:English
Published: New York Humana Press Inc 01.10.2011
Springer Nature B.V
Subjects:
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
Anticonvulsants
Hyponatremia
Subarachnoid hemorrhage
Endovascular
Aneurysm
Critical care
Vasospasm
Fever
ISSN:1541-6933, 1556-0961, 1556-0961
Online Access:Get full text
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Summary: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.
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ISSN:1541-6933
1556-0961
1556-0961
DOI:10.1007/s12028-011-9605-9