Abhijit V Lele, Ananya Abate Shiferaw, Marie Angele Theard, Monica S Vavilala, Cristiane Tavares, Ruquan Han, Denekew Assefa, Mihret Dagne Alemu, Charu Mahajan, Monica S Tandon, Neeta V Karmarkar, Vasudha Singhal, Ritesh Lamsal, Umeshkumar Athiraman
{"title":"动脉瘤性蛛网膜下腔出血破裂脑动脉瘤显微手术修复患者围手术期护理的全球综述。","authors":"Abhijit V Lele, Ananya Abate Shiferaw, Marie Angele Theard, Monica S Vavilala, Cristiane Tavares, Ruquan Han, Denekew Assefa, Mihret Dagne Alemu, Charu Mahajan, Monica S Tandon, Neeta V Karmarkar, Vasudha Singhal, Ritesh Lamsal, Umeshkumar Athiraman","doi":"10.1097/ANA.0000000000000913","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>To describe the perioperative care of patients with aneurysmal subarachnoid hemorrhage (aSAH) who undergo microsurgical repair of a ruptured intracerebral aneurysm.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>This global survey identifies differences in reported practices during the perioperative management of patients with aSAH.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"164-171"},"PeriodicalIF":2.3000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10584987/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Global Review of the Perioperative Care of Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Microsurgical Repair of Ruptured Intracerebral Aneurysm.\",\"authors\":\"Abhijit V Lele, Ananya Abate Shiferaw, Marie Angele Theard, Monica S Vavilala, Cristiane Tavares, Ruquan Han, Denekew Assefa, Mihret Dagne Alemu, Charu Mahajan, Monica S Tandon, Neeta V Karmarkar, Vasudha Singhal, Ritesh Lamsal, Umeshkumar Athiraman\",\"doi\":\"10.1097/ANA.0000000000000913\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>To describe the perioperative care of patients with aneurysmal subarachnoid hemorrhage (aSAH) who undergo microsurgical repair of a ruptured intracerebral aneurysm.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>This global survey identifies differences in reported practices during the perioperative management of patients with aSAH.</p>\",\"PeriodicalId\":16550,\"journal\":{\"name\":\"Journal of neurosurgical anesthesiology\",\"volume\":\" \",\"pages\":\"164-171\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10584987/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurosurgical anesthesiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/ANA.0000000000000913\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgical anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ANA.0000000000000913","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
A Global Review of the Perioperative Care of Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Microsurgical Repair of Ruptured Intracerebral Aneurysm.
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.
期刊介绍：
The Journal of Neurosurgical Anesthesiology (JNA) is a peer-reviewed publication directed to an audience of neuroanesthesiologists, neurosurgeons, neurosurgical monitoring specialists, neurosurgical support staff, and Neurosurgical Intensive Care Unit personnel. The journal publishes original peer-reviewed studies in the form of Clinical Investigations, Laboratory Investigations, Clinical Reports, Review Articles, Journal Club synopses of current literature from related journals, presentation of Points of View on controversial issues, Book Reviews, Correspondence, and Abstracts from affiliated neuroanesthesiology societies.
JNA is the Official Journal of the Society for Neuroscience in Anesthesiology and Critical Care, the Neuroanaesthesia and Critical Care Society of Great Britain and Ireland, the Association de Neuro-Anesthésiologie Réanimation de langue Française, the Wissenschaftlicher Arbeitskreis Neuroanästhesie der Deutschen Gesellschaft fur Anästhesiologie und Intensivmedizen, the Arbeitsgemeinschaft Deutschsprachiger Neuroanästhesisten und Neuro-Intensivmediziner, the Korean Society of Neuroanesthesia, the Japanese Society of Neuroanesthesia and Critical Care, the Neuroanesthesiology Chapter of the Colegio Mexicano de Anesthesiología, the Indian Society of Neuroanesthesiology and Critical Care, and the Thai Society for Neuroanesthesia.
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