Guideline-recommended basic parameter adherence in neurocritical care stroke patients: Observational multicenter individual participant data analysis

神经重症监护 医学 观察研究 指南 血压 重症监护医学 冲程(发动机) 神经血管束 颅内压 急诊医学 重症监护 麻醉 内科学 外科 病理 工程类 机械工程
作者
Anne Mrochen,Omar Alhaj Omar,Johann Pelz,Dominik Michalski,Hermann Neugebauer,Dominik Lehrieder,Benjamin Knier,Corinna Ringmaier,Henning Stetefeld,Silvia Schönenberger,Min Chen,Hauke Schneider,Angelika Alonso,Hendrik Lesch,Andreas Totzek,Friedrich Erdlenbruch,Birgit Hiller,Norma J Diel,André Worm,Christian Claudi,Stefan T. Gerner,Hagen B. Huttner,Patrick Schramm
出处
期刊:European stroke journal [SAGE Publishing]
标识
DOI:10.1177/23969873241289360
摘要

Introduction: Neurocritical care patients with neurovascular disease often face poor long-term outcomes, highlighting the pivotal role of evidence-based interventions. Although International Guidelines emphasize managing basic physiological parameters like temperature, blood glucose, blood pressure, and oxygen levels, physician adherence to these targets remains uncertain. This study aimed to assess adherence to guideline-based treatment targets for basic physiological parameters in neurocritical care. Patients and Methods: This multicenter observational study was conducted across eight tertiary University Hospitals in Germany analyzed 474 patients requiring mechanical ventilation (between January 1st and December 31st, 2021). Adherence was defined as the rate of measurements within therapeutic ranges for systolic blood pressure (situation-adapted), mean blood pressure (MAP, 60–90 mmHg), glucose levels (80–180 mg/dl), body temperature (<37.5°C), partial arterial pressure of oxygen (PaO 2 ) 80–120 mmHg und partial arterial pressure of carbon dioxide (PaCO 2 ) 35–45 mmHg during the initial 96 h of hospitalization in 4 hour-intervals. Results: Overall, 70.7% of all measurements were within the predetermined therapeutic ranges including SBP (71.3%), temperature (68.3%), MAP (71.4%), PaO 2 (65.2%), PaCO 2 (75.0%) and blood glucose (80.7%). Discussion and Conclusion: This multicenter study demonstrates adherence to guideline-based treatment targets, underscoring the high standards maintained by neurological intensive care units. Our study offers valuable insights into adherence to guideline-based treatment targets for neurocritical care patients in Germany. To improve patient care and optimize therapeutic strategies in neurovascular diseases, further research is needed to examine the impact of these adherence parameters on long-term outcomes.
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