Table 2 Questions and answers on acute ischemic stroke

Which is the percentage of acute ischemic stroke (AIS) that undergo pharmacological thrombolysis/year in your institution?

No answer

 < 10%

10–30%

30–50%

 > 50%

28 (18%)

23 (15%)

37 (24%)

28 (18%)

38 (25%)

Which is the percentage of AIS that undergo mechanic thrombectomy/year in your institution?

No answer

 < 10%

10–30%

30–50%

 > 50%

28 (18%)

48 (31%)

32 (21%)

29 (19%)

17 (11%)

Do you have a standardized protocol for arterial blood pressure management in patients with ischemic stroke?

No answer

Yes

No

28 (18%)

71 (46%)

55 (36%)

Do you routinely perform an echocardiography at the bedside in AIS patients during the first 24 h of admission to rule out possible acute LV dysfunction?

No answer

Yes

No

Selected cases

28 (18%)

57 (37%)

55 (36%)

14 (9%)

How many AIS patients receive standard cardiac output monitoring in your institution?

No answer

 < 20%

30–50%

50%

28 (18%)

95 (62%)

19 (12%)

12 (8%)

Do you usually assess capillary refill test at the bedside in AIS patients?

No answer

Yes

No

28 (18%)

62 (40%)

64 (42%)

Which is the arterial blood pressure target that you use in patients eligible for iv thrombolysis?

No answer

 < 140/90

 < 160/90

185/110

Reduction of 15% of baseline ABP

Other

28 (18%)

16 (10%)

54 (35%)

33 (21%)

15 (10%)

8 (5%)

Which is the arterial blood pressure target that you use in patients not eligible for iv thrombolysis?

No answer

 < 140/90

 < 160/90

185/110

Reduction of 15% of baseline ABP

Other

28 (18%)

13 (8%)

44 (29%)

42 (27%)

17 (11%)

10 (7%)

Which is the arterial blood pressure target that you use in patients eligible after mechanical thrombectomy?

No answer

 < 140/90

 < 160/90

185/110

Reduction of 15% of baseline ABP

Other

28 (18%)

28 (18%)

46 (30%)

26 (17%)

11 (7%)

15 (10%)

Which standard hemodynamic monitoring do you use in case of patient with ischemic stroke? (more than one anwer)

No answer

Basic monitoring (NIBP, ECG)

Basic monitoring

(invasive blood pressure, ECG)

Advanced non-invasive hemodynamic monitoring

Advanced invasive monitoring

Echocardiography

28 (18%)

53 (34%)

92 (60%)

16 (10%)

9 (6%)

44 (29%)

Which is the commonest indication for starting an advanced hemodynamic monitoring in acute ischemic stroke patients in your unit? (i.e., the use of more than invasive arterial blood pressure)?

No answer

Patients developing cardiovascular complications (i.e., pulmonary edema, cardiogenic shock, etc.)

Sepsis/septic shock

Difficult blood pressure management

Patients developing neurological complications (i.e., neuroworsening)

28 (18%)

52 (34%)

39 (25%)

25 (16%)

10 (6%)

How do you initially manage hypotension in AIS patients?

No answer

Mean arterial pressure-based protocol

No specific protocol

Fluids

Cardiac output-based protocol

28 (18%)

85 (55%)

21 (14%)

14 (9%)

6 (4%)

Which drugs are used as first line to increase blood pressure in your ICU in patients with preserved heart function?

No answer

Norepinephrine

Dobutamine

Vasopressin

Metaraminol

28 (18%)

123 (80%)

2 (1%)

1 (< 1%)

1 (< 1%)

Which drugs are used as second line to increase blood pressure in your ICU in patients with preserved heart function?

No answer

Vasopressin

Epinephrine

Dobutamine

Dopamine

Norepinephrine

Terlipressin

Phenylephrine

None of the above

28 (18%)

58 (38%)

27 (18%)

19 (12%)

4 (3%)

5 (3%)

2 (1%)

1 (< 1%)

2 (1%)

Which drugs are used as first line to decrease blood pressure in your ICU?

No answer

Urapidil

Beta blockers

Calcium channel blockers

Clonidine

Nitrates

ACE inhibitors

Angiotensin receptor antagonists

Azamethonium

28 (18%)

37 (24%)

33 (21%)

23 (15%)

21 (14%)

6 (4%)

3 (2%)

2 (1%)

1 (< 1%)

Which drugs are used as second line to decrease blood pressure in your ICU?

No answer

Beta blockers

Calcium channel blockers

Clonidine

Urapidil

Nitrates

ACE inhibitors

Angiotensin receptor antagonists

Hydralazine

28 (18%)

34 (22%)

32 (21%)

27 (18%)

11 (7%)

10 (6%)

7 (5%)

4 (3%)

1 (< 1%)

How frequently do you monitor fluid balance in patients with ischemic stroke?

No answer

Every hour

Every two hours

Every 4 h

Every 8 h

Every 12 h

Every 24 h

We don’t monitor fluid balance

28 (18%)

48 (31%)

22 (14%)

9 (6%)

1 (1%)

22 (14%)

22 (14%)

2 (1%)

Which is your net daily fluid balance target (i.e., all fluids INPUT minus all fluids OUTPUT)?

No answer

Negative

Neutral

Positive

28 (18%)

10 (6%)

96 (62%)

20 (13%)

Which is the first line fluid therapy you usually use?

No answer

Ringer lactate

Normal saline

Plasmalyte

Albumin

Hypertonic saline

Other

28 (18%)

54 (35%)

49 (32%)

6 (4%)

3 (2%)

2 (1%)

30 (19%)