A Global Review of the Perioperative Care of Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Microsurgical Repair of Ruptured Intracerebral Aneurysm
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved..
INTRODUCTION: To describe the perioperative care of patients with aneurysmal subarachnoid hemorrhage (aSAH) who undergo microsurgical repair of a ruptured intracerebral aneurysm.
METHODS: An English language survey examined 138 areas of the perioperative care of patients with aSAH. Reported practices were categorized as those reported by <20%, 21% to 40%, 41% to 60%, 61% to 80%, and 81% to 100% of participating hospitals. Data were stratified by Worldbank country income level (high-income or low/middle-income). Variation between country-income groups and between countries was presented as an intracluster correlation coefficient (ICC) and 95% confidence interval (CI).
RESULTS: Forty-eight hospitals representing 14 countries participated in the survey (response rate 64%); 33 (69%) hospitals admitted ≥60 aSAH patients per year. Clinical practices reported by 81 to 100% of the hospitals included placement of an arterial catheter, preinduction blood type/cross match, use of neuromuscular blockade during induction of general anesthesia, delivering 6 to 8 mL/kg tidal volume, and checking hemoglobin and electrolyte panels. Reported use of intraoperative neurophysiological monitoring was 25% (41% in high-income and 10% in low/middle-income countries), with variation between Worldbank country-income group (ICC 0.15, 95% CI 0.02-2.76) and between countries (ICC 0.44, 95% CI 0.00-0.68). The use of induced hypothermia for neuroprotection was low (2%). Before aneurysm securement, variable in blood pressure targets was reported; systolic blood pressure 90 to 120 mm Hg (30%), 90 to 140 mm Hg (21%), and 90 to 160 mmHg (5%). Induced hypertension during temporary clipping was reported by 37% of hospitals (37% each in high and low/middle-income countries).
CONCLUSIONS: This global survey identifies differences in reported practices during the perioperative management of patients with aSAH.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Journal of neurosurgical anesthesiology - 36(2024), 2 vom: 01. Apr., Seite 164-171 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lele, Abhijit V [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 16.04.2024 Date Revised 17.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/ANA.0000000000000913 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM35796361X |
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| 041 | |a eng | ||
| 100 | 1 | |a Lele, Abhijit V |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A Global Review of the Perioperative Care of Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Microsurgical Repair of Ruptured Intracerebral Aneurysm |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 16.04.2024 | ||
| 500 | |a Date Revised 17.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: To describe the perioperative care of patients with aneurysmal subarachnoid hemorrhage (aSAH) who undergo microsurgical repair of a ruptured intracerebral aneurysm | ||
| 520 | |a METHODS: An English language survey examined 138 areas of the perioperative care of patients with aSAH. Reported practices were categorized as those reported by <20%, 21% to 40%, 41% to 60%, 61% to 80%, and 81% to 100% of participating hospitals. Data were stratified by Worldbank country income level (high-income or low/middle-income). Variation between country-income groups and between countries was presented as an intracluster correlation coefficient (ICC) and 95% confidence interval (CI) | ||
| 520 | |a RESULTS: Forty-eight hospitals representing 14 countries participated in the survey (response rate 64%); 33 (69%) hospitals admitted ≥60 aSAH patients per year. Clinical practices reported by 81 to 100% of the hospitals included placement of an arterial catheter, preinduction blood type/cross match, use of neuromuscular blockade during induction of general anesthesia, delivering 6 to 8 mL/kg tidal volume, and checking hemoglobin and electrolyte panels. Reported use of intraoperative neurophysiological monitoring was 25% (41% in high-income and 10% in low/middle-income countries), with variation between Worldbank country-income group (ICC 0.15, 95% CI 0.02-2.76) and between countries (ICC 0.44, 95% CI 0.00-0.68). The use of induced hypothermia for neuroprotection was low (2%). Before aneurysm securement, variable in blood pressure targets was reported; systolic blood pressure 90 to 120 mm Hg (30%), 90 to 140 mm Hg (21%), and 90 to 160 mmHg (5%). Induced hypertension during temporary clipping was reported by 37% of hospitals (37% each in high and low/middle-income countries) | ||
| 520 | |a CONCLUSIONS: This global survey identifies differences in reported practices during the perioperative management of patients with aSAH | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Shiferaw, Ananya Abate |e verfasserin |4 aut | |
| 700 | 1 | |a Theard, Marie Angele |e verfasserin |4 aut | |
| 700 | 1 | |a Vavilala, Monica S |e verfasserin |4 aut | |
| 700 | 1 | |a Tavares, Cristiane |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Ruquan |e verfasserin |4 aut | |
| 700 | 1 | |a Assefa, Denekew |e verfasserin |4 aut | |
| 700 | 1 | |a Dagne Alemu, Mihret |e verfasserin |4 aut | |
| 700 | 1 | |a Mahajan, Charu |e verfasserin |4 aut | |
| 700 | 1 | |a Tandon, Monica S |e verfasserin |4 aut | |
| 700 | 1 | |a Karmarkar, Neeta V |e verfasserin |4 aut | |
| 700 | 1 | |a Singhal, Vasudha |e verfasserin |4 aut | |
| 700 | 1 | |a Lamsal, Ritesh |e verfasserin |4 aut | |
| 700 | 1 | |a Athiraman, Umeshkumar |e verfasserin |4 aut | |
| 700 | 0 | |a Global-SAH project collaborators |e verfasserin |4 aut | |
| 700 | 1 | |a Chui, Jason |e investigator |4 oth | |
| 700 | 1 | |a Takala, Riikka |e investigator |4 oth | |
| 700 | 1 | |a Bruder, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Kunze-Szikszay, Nils |e investigator |4 oth | |
| 700 | 1 | |a Carrero, Enrique |e investigator |4 oth | |
| 700 | 1 | |a Heller, Benjamin J |e investigator |4 oth | |
| 700 | 1 | |a Bebawy, John F |e investigator |4 oth | |
| 700 | 1 | |a Pasternak, Jeffrey J |e investigator |4 oth | |
| 700 | 1 | |a Paisansathan, Chanannait |e investigator |4 oth | |
| 700 | 1 | |a Vagnerova, Kamila |e investigator |4 oth | |
| 700 | 1 | |a Burbridge, Mark |e investigator |4 oth | |
| 700 | 1 | |a Rajan, Shobana |e investigator |4 oth | |
| 700 | 1 | |a Pollard James Williams, Richard J |e investigator |4 oth | |
| 700 | 1 | |a Wyler, David A |e investigator |4 oth | |
| 700 | 1 | |a Chakraborty, Indranil |e investigator |4 oth | |
| 700 | 1 | |a Nadler, Jacob W |e investigator |4 oth | |
| 700 | 1 | |a Bustillo, Maria |e investigator |4 oth | |
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