Table 3 Questions and answers on hemorrhagic stroke

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

No answer

Yes

No

35 (23%)

66 (43%)

53 (34%)

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

No answer

Yes

No

Selected cases

35 (23%)

52 (34%)

59 (38%)

8 (5%)

How many patients with hemorrhagic stroke receive cardiac output monitoring in your institution?

No answer

 < 20%

30–50%

50%

35 (23%)

82 (53%)

23 (15%)

9 (8%)

Do you usually assess CRT (capillary refill time) at the bedside in patients with hemorrhagic stroke as part of routinely hemodynamic assessment?

No answer

Yes

No

35 (23%)

57 (37%)

62 (40%)

Which is the arterial blood pressure target that you use in patients after intracranial hemorrhage?

No answer

 < 140/90

 < 160/90

185/110

Reduction of 15% of the initial arterial blood pressure

other

35 (23%)

55 (36%)

44 (29%)

7 (5%)

8 (5%)

5 (3%)

Which hemodynamic monitoring do you use in case of patient with hemorrhagic stroke?

No answer

Basic monitoring (NIBP, ECG)

Basic monitoring (Invasive blood pressure, ECG)

Advanced non-invasive hemodynamic monitoring

Advanced invasive monitoring

Echocardiography

35 (23%)

19 (12%)

80 (52%)

2 (1%)

9 (6%)

9 (6%)

Which are the indications for advanced hemodynamic monitoring hemorrhagic stroke patients (i.e., the use of more than invasive arterial blood pressure)?

No answer

In all patients admitted to the ICU

In patients requiring drugs to increase or reduce arterial blood pressure

In patients with cardiovascular (i.e., pulmonary edema, cardiogenic shock, etc.) (neuroworsening)

In patients with neurological complications (i.e., neuroworsening)

Never

Other

35 (23%)

15 (10%)

40 (26%)

54 (35%)

2 (1%)

5 (3%)

3 (2%)

How do you manage hypotension in patients with hemorrhagic stroke?

No answer

Mean arterial pressure-based protocol

No specific protocol

Cardiac output-based protocol

Fluids

35 (23%)

82 (53%)

25 (16%)

7 (5%)

5 (3%)

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

No answer

Norepinephrine

Vasopressin

Dopamine

Epinephrine

Metaraminol

Dobutamine

35 (23%)

114 (74%)

2 (1%)

1 (< 1%)

1 (< 1%)

1 (< 1%)

1 (< 1%)

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

No answer

Vasopressin

Epinephrine

Dobutamine

Norepinephrine

Dopamine

Phenylephrine

35 (23%)

61 (38%)

24 (16%)

22 (14%)

8 (5%)

4 (3%)

1 (< 1%)

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

No answer

Beta blockers

Calcium channel blockers

Clonidine

Urapidil

Nitrates

ACE inhibitors

Angiotensin receptor antagonists

35 (23%)

33 (21%)

23 (15%)

16 (10%)

12 (8%)

7 (5%)

1 (< 1%)

1 (< 1%)

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

No answer

Beta blockers

Clonidine

Calcium channel blockers

ACE inhibitors

Urapidil

Nitrates

Angiotensin receptor antagonists

35 (23%)

35 (23%)

32 (21%)

22 (14%)

10 (6%)

12 (8%)

7 (5%)

1 (< 1%)

How frequently do you monitor fluid balance?

No answer

Every hour

Every 2 h

Every 4 h

Every 12 h

Every 24 h

35 (23%)

48 (31%)

18 (12%)

9 (6%)

23 (15%)

21 (14%)

Which is your net daily fluid balance target?

No answer

Negative

Neutral

Positive

Other

35 (23%)

9 (6%)

91 (59%)

16 (10%)

3 (2%)

Which is the first-line fluid therapy you usually use?

No answer

Ringer lactate

Normal saline

Hypertonic saline

Plasmalyte

Other

35 (23%)

52 (33%)

43 (28%)

7 (5%)

6 (4%)

11 (7%)