BACKGROUND: Patients with aneurysmal subarachnoid hemorrhage (SAH) are routinely admitted to the intensive care unit for the management of neurological and systemic complications. OBJECTIVE: To determine the clinical practices of intensive care physicians treating SAH, and to evaluate the relationship between these practices and published evidence. DESIGN: Survey. PARTICIPANTS: Physicians identified through the Society of Critical Care Medicine (SCCM), the European Society of Intensive Care Medicine (ESICM), and the Neurocritical Care Society (NCS). INTERVENTIONS: The research team classified published clinical research on key interventions in SAH diagnosis and therapy, and then generated a 45-item online questionnaire which was distributed to SCCM, NCS, and ESICM members. RESULTS: There were 626 completed surveys, 51% from the USA or Canada, 35% from Europe, and 14% from other regions. Respondents included anesthesiologists (38%), internists (29%), neurologists (14%), and neurosurgeons (8%). Agreement with selected evidence-based recommendations was variable (39-92%) and did not depend on the quality of the supporting data. Significant practice differences were noted between respondents from North America and Europe, and between those working in high and low-volume centers (respectively >40 and </=40 SAH cases per year). CONCLUSIONS: This study demonstrates that the practices of intensive care physicians treating SAH are heterogeneous and often at variance with available evidence.
BACKGROUND:Patients with aneurysmal subarachnoid hemorrhage (SAH) are routinely admitted to the intensive care unit for the management of neurological and systemic complications. OBJECTIVE: To determine the clinical practices of intensive care physicians treating SAH, and to evaluate the relationship between these practices and published evidence. DESIGN: Survey. PARTICIPANTS: Physicians identified through the Society of Critical Care Medicine (SCCM), the European Society of Intensive Care Medicine (ESICM), and the Neurocritical Care Society (NCS). INTERVENTIONS: The research team classified published clinical research on key interventions in SAH diagnosis and therapy, and then generated a 45-item online questionnaire which was distributed to SCCM, NCS, and ESICM members. RESULTS: There were 626 completed surveys, 51% from the USA or Canada, 35% from Europe, and 14% from other regions. Respondents included anesthesiologists (38%), internists (29%), neurologists (14%), and neurosurgeons (8%). Agreement with selected evidence-based recommendations was variable (39-92%) and did not depend on the quality of the supporting data. Significant practice differences were noted between respondents from North America and Europe, and between those working in high and low-volume centers (respectively >40 and </=40 SAH cases per year). CONCLUSIONS: This study demonstrates that the practices of intensive care physicians treating SAH are heterogeneous and often at variance with available evidence.
Authors: M R Mayberg; H H Batjer; R Dacey; M Diringer; E C Haley; R C Heros; L L Sternau; J Torner; H P Adams; W Feinberg Journal: Stroke Date: 1994-11 Impact factor: 7.914
Authors: DeWitte T Cross; David L Tirschwell; Mary Ann Clark; Dan Tuden; Colin P Derdeyn; Christopher J Moran; Ralph G Dacey Journal: J Neurosurg Date: 2003-11 Impact factor: 5.115
Authors: Katja E Wartenberg; J Michael Schmidt; Jan Claassen; Richard E Temes; Jennifer A Frontera; Noeleen Ostapkovich; Augusto Parra; E Sander Connolly; Stephan A Mayer Journal: Crit Care Med Date: 2006-03 Impact factor: 7.598
Authors: Andrew J Molyneux; Richard S C Kerr; Ly-Mee Yu; Mike Clarke; Mary Sneade; Julia A Yarnold; Peter Sandercock Journal: Lancet Date: 2005 Sep 3-9 Impact factor: 79.321
Authors: Rachel Meyer; Steven Deem; N David Yanez; Michael Souter; Arthur Lam; Miriam M Treggiari Journal: Neurocrit Care Date: 2011-02 Impact factor: 3.210
Authors: Vishank A Shah; Syed Omar Kazmi; Rahul Damani; Alyssa Hartsell Harris; Samuel F Hohmann; Eusebia Calvillo; Jose I Suarez Journal: Front Neurol Date: 2022-06-16 Impact factor: 4.086
Authors: Daniel Hänggi; Nima Etminan; Stephan A Mayer; E Francois Aldrich; Michael N Diringer; Erich Schmutzhard; Herbert J Faleck; David Ng; Benjamin R Saville; R Loch Macdonald Journal: Neurocrit Care Date: 2019-02 Impact factor: 3.210
Authors: Gabriel Alcalá-Cerra; Juan J Gutiérrez Paternina; María E Buendía de Ávila; Edgar I Preciado Mesa; Rubén Sabogal Barrios; Lucía M Niño-Hernández; Keith Suárez Jaramillo Journal: Surg Neurol Int Date: 2011-09-17
Authors: Andreas H Kramer; Michael N Diringer; Jose I Suarez; Andrew M Naidech; Loch R Macdonald; Peter D Le Roux Journal: Crit Care Date: 2011-01-18 Impact factor: 9.097
Authors: Shaurya Taran; Vatsal Trivedi; Jeffrey M Singh; Shane W English; Victoria A McCredie Journal: Neurocrit Care Date: 2020-06 Impact factor: 3.210