학술논문
Early management of patients with aneurysmal subarachnoid hemorrhage in a hospital without neurosurgical/neuroendovascular facilities: a consensus and clinical recommendations of the Italian Society of Anesthesia and Intensive Care (SIAARTI)
Document Type
article
Author
Edoardo Picetti; Maurizio Berardino; Alessandro Bertuccio; Rita Bertuetti; Edoardo Pietro Boccardi; Anselmo Caricato; Carlo Alberto Castioni; Marco Cenzato; Arturo Chieregato; Giuseppe Citerio; Paolo Gritti; Luca Longhi; Costanza Martino; Marina Munari; Sandra Rossi; Nino Stocchetti; Tommaso Zoerle; Frank Rasulo; Chiara Robba
Source
Journal of Anesthesia, Analgesia and Critical Care, Vol 1, Iss 1, Pp 1-7 (2021)
Subject
Language
English
ISSN
2731-3786
Abstract
Abstract Background The immediate management of subarachnoid hemorrhage (SAH) patients in hospitals without neurosurgical/neurointerventional facilities and their transfer to a specialized center is challenging and not well covered in existing guidelines. To address these issues, we created a consensus of experts endorsed by the Italian Society of Anesthesia and Intensive Care (SIAARTI) to provide clinical guidance. Methods A multidisciplinary consensus panel composed by 19 physicians selected for their established clinical and scientific expertise in the acute management of SAH patients with different specializations (anesthesia/intensive care, neurosurgery and interventional neuroradiology) was created. A modified Delphi approach was adopted. Results A total of 14 statements have been discussed. Consensus was reached on 11 strong recommendations and 2 weak recommendations. In one case, where consensus could not be agreed upon, no recommendation could be provided. Conclusions Management of SAH in a non-specialized setting and early transfer are difficult and may have a critical impact on outcome. Clinical advice, based on multidisciplinary consensus, might be helpful. Our recommendations cover most, but not all, topics of clinical relevance.