Current intensive care management proposals after aneurysmal subarachnoid hemorrhage

Abstract BACKGROUND In patients with aneurysmal subarachnoid hemorrhage (SAH), preliminary results indicate that the amplitude of the single intracranial pressure (ICP) wave is a better predictor of the early clinical state and 6-month outcome than the mean ICP. OBJECTIVE To perform a randomized and blinded single-center trial comparing the effect of mean ICP vs mean ICP wave amplitude (MWA)-guided intensive care management on early clinical state and outcome in patients with aneurysmal SAH. METHODS Patients were randomized to 2 different types of ICP management: maintenance of mean ICP less than 20 mm Hg and MWA less than 5 mm Hg. Early clinical state was assessed daily using the Glasgow Coma Scale. The primary efficacy variable was 12-month outcome in terms of the Rankin Stroke Score. RESULTS Ninety-seven patients were included in the study. There were no significant differences in treatment between the 2 groups apart from a larger volume of cerebrospinal fluid drained during week 1 in the MWA group. There was a tendency toward higher Glasgow Coma Scale scores in the MWA group during weeks 1 (P = .08) and 2 (P = .07). Outcome in terms of Rankin Stroke Score at 12 months was significantly better in the MWA group (P < .05). CONCLUSION This randomized and blinded trial disclosed a significant better primary efficacy variable (Rankin Stroke Score after 12 months) in the MWA patient group. We suggest that proactive intensive care management with MWA-tailored cerebrospinal fluid drainage during the first week improves aneurysmal SAH outcome.

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A Randomized and Blinded Single-Center Trial Comparing the Effect of Intracranial Pressure and Intracranial Pressure Wave Amplitude-Guided Intensive Care Management on Early Clinical State and 12-Month Outcome in Patients With Aneurysmal Subarachnoid Hemorrhage

Yearbook of Anesthesiology and Pain Management ◽

10.1016/j.yane.2012.01.045 ◽

2012 ◽

Vol 2012 ◽

pp. 182-184

Author(s):

M. Mathru

Keyword(s):

Intensive Care ◽

Intracranial Pressure ◽

Pressure Wave ◽

Care Management ◽

Wave Amplitude ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Clinical State ◽

Single Center ◽

Intensive Care Management ◽

Pressure Wave Amplitude

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Intensive care management of subarachnoid hemorrhage

Current Opinion in Anaesthesiology ◽

10.1097/00001503-199504000-00007 ◽

1995 ◽

Vol 8 (2) ◽

pp. 139-144 ◽

Cited By ~ 1

Author(s):

Stephan A. Mayer

Keyword(s):

Intensive Care ◽

Subarachnoid Hemorrhage ◽

Care Management ◽

Intensive Care Management

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Recommendations for Intensive Care Management in Small Animals Following Anaesthesia

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633069 ◽

1992 ◽

Vol 05 (02) ◽

pp. 66-70

Author(s):

Karol Mathews ◽

Doris Dyson

Keyword(s):

Intensive Care ◽

Care Management ◽

Small Animal ◽

Small Animals ◽

Monitoring Equipment ◽

Intensive Care Management ◽

Good Communication

Intensive care management can be provided in a small animal facility by centralisation of emergency and monitoring equipment. Good communication between all personnel involved in the case ensures that staff are prepared for complications that could arise related to recovery from anaesthesia.

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Drug Overdosage in Children

Anaesthesia and Intensive Care ◽

10.1177/0310057x7400200403 ◽

1974 ◽

Vol 2 (4) ◽

pp. 303-309 ◽

Cited By ~ 6

Author(s):

T. C. K. Brown ◽

F. I. Bishop ◽

G. C. Mullins

Keyword(s):

Intensive Care ◽

Respiratory Failure ◽

Emergency Treatment ◽

Care Management ◽

Tricyclic Antidepressants ◽

Conscious State ◽

Circulatory Failure ◽

Intensive Care Management ◽

Drug Overdosage

The epidemiology and prevention of drug overdosage in children is discussed. The emergency treatment of acute drug overdosage is outlined together with aspects of the intensive care management in relation to conscious state, convulsions, respiratory failure, circulatory failure and arrhythmias with some emphasis on tricyclic antidepressants.

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