Encuesta sobre la práctica y actuación de los anestesiólogos ante una hemorragia subaracnoidea aneurismática de origen no traumático

Rama-Maceiras, P.; Fàbregas, Neus; Ingelmo, Ildefonso; Hérnández-Palazón, J

doi:10.1016/s0034-9356(09)70314-7

Cited by 7 publications

(5 citation statements)

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“…Other studies have reported its use as frequent as 81.8% of cases. [11] Although more than half of the respondents recognized that glucocorticoids in patients with SAH have no clinical effect, nearly 40% reported using them frequently or routinely. The ineffectiveness of this group of drugs has been demonstrated in multiple clinical trials and a meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…[4] It seems to be a global problem since this finding is similar to what is described in Germany (35%) but lower than that reported in two studies conducted in Europe (78% and 78.5%). [1113]…”

Section: Discussionmentioning

confidence: 99%

“…This frequency of use of statins is the highest compared with previous surveys, reflecting the effect of these outdated publications. [11] The beneficial effects of magnesium sulfate infusion also have not been proven with certainty, so its use has been poorly implemented. [1821] In this survey, 10.3% reported using it as usual or routinely which is consistent with previous studies (6 to 19.4%).…”

Section: Discussionmentioning

confidence: 99%

“…[1821] In this survey, 10.3% reported using it as usual or routinely which is consistent with previous studies (6 to 19.4%). [111318] Studies with anti-fibrinolytics have found a reduction in the incidence of re-bleeding by 40%; but this is offset by a high rate of cerebral ischemia and poor neurological outcome. [12] Therefore, this can explain why about 90% of the participants of this study do not use it which is in accordance to current recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…[26] Still, in many situations, the physician-indicated therapies are found to be different from evidence-based recommendations. [1113] Causes of these inconsistencies have not been established, but we believe these could be due to information access, variable continued medical education, neurosurgeon's training and experience, resources on each location, and others.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms by neurosurgeons in Colombia: A survey

Alcalá-Cerra

Jj²,

Me³

et al. 2011

Surg Neurol Int

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Background:Trends in management of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms among neurosurgeons is very variable and had not been previously described in any Latin American country. This study was conducted to determine the preferences of Colombian neurosurgeons in pharmacologic, surgical, and endovascular management of patients with aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms.Methods:A survey-based descriptive study was performed in a sample of members from the Colombian Association of Neurosurgery. Questions about pharmacologic, surgical, and endovascular management of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysm were carried out. We calculated the mean and the standard deviation of the results obtained from the continuous variables. The results of the categorical variables are presented as percentages.Results:The preference of medication with poor clinical evidence, such as magnesium sulfate, aspirin, statins, and anti-fibrinolytics was lower than 10%. The use of intravenous nimodipine and systemic glucocorticoids was as high as 31%. The availability of endovascular therapy was 69%. The indication for treatment of patients with unruptured intracranial aneurysms that required intervention was less than 13.8%. In patients with ruptured or unruptured intracranial aneurysms, coiling was the preferred method for exclusion.Conclusions:Reported compliance of evidence-based clinical guidelines was similar to that described in developed countries, and even better. However, there is little agreement in treating patients with unruptured intracranial aneurysms. For other issues, the conducts reported by Colombian neurosurgeons are in accordance with the current guidelines.

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Section: Discussionmentioning

confidence: 99%