Early Management of Patients with Aneurysmal Subarachnoid Hemorrhage in a Hospital with Neurosurgical/neuroendovascular Facilities: a Consensus and Clinical Recommendations of the Italian Society of Anesthesia and Intensive Care (SIAARTI)-part 2

Overview

Journal J Anesth Analg Crit Care

Date 2023 Jun 29

PMID 37386571

Authors

Edoardo Picetti

Andrea Barbanera

Claudio Bernucci

Alessandro Bertuccio

Federico Bilotta

Edoardo Pietro Boccardi

Tullio Cafiero

Anselmo Caricato

Carlo Alberto Castioni

Marco Cenzato

Arturo Chieregato

Giuseppe Citerio

Paolo Gritti

Luigi Lanterna

Roberto Menozzi

Marina Munari

Pietro Panni

Sandra Rossi

Nino Stocchetti

Carmelo Sturiale

Tommaso Zoerle

Gianluigi Zona

Frank Rasulo

Chiara Robba

Affiliations

Soon will be listed here.

Abstract

Background: Questions remain on the optimal management of subarachnoid hemorrhage (SAH) patients once they are admitted to the referring center, before and after the aneurysm treatment. 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 regarding this topic. Specifically, in this manuscript (part 2), we aim to provide a list of experts' recommendations regarding the management of SAH patients in a center with neurosurgical/neuroendovascular facilities after aneurysm treatment.

Methods: A multidisciplinary consensus panel composed by 24 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 33 statements were discussed, voted, and approved. Consensus was reached on 30 recommendations (28 strong and 2 weak). In 3 cases, where consensus could not be agreed upon, no recommendation was provided.

Conclusions: This consensus provides practical recommendations (and not mandatory standard of practice) to support clinician's decision-making in the management of SAH patients in centers with neurosurgical/neuroendovascular facilities after aneurysm securing.

Citing Articles

Validation of the accuracy of the modified World Federation of Neurosurgical Societies subarachnoid hemorrhage grading scale for predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage.

Nguyen T, Mai T, Vu L, Dao C, Ngo H, Hoang H PLoS One. 2023; 18(8):e0289267.

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