Table 4 Questions and answers on subarachnoid hemorrhage

Which is the percentage of patients who undergo aneurysm clipping/year in your institution?

No answer

 < 10%

10–30%

30–50%

50%

43 (28%)

35 (23%)

29 (19%)

36 (23%)

11 (7%)

Which is the percentage of SAH that undergo aneurism coiling/year in your institution?

No answer

 < 10%

10–30%

30–50%

50%

43 (28%)

21 (14%)

15 (10%)

27 (18%)

48 (31%)

Do you have a standardized protocol for arterial blood pressure management in patients with subarachnoid hemorrhage?

No answer

Yes

No

43 (28%)

67 (44%)

44 (29%)

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

No answer

Yes

No

Selected cases

43 (28%)

59 (38%)

42 (27%)

10 (6%)

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

No answer

 < 20%

30–50%

50%

43 (28%)

67 (44%)

26 (17%)

18 (12%)

Do you usually assess CRT at the bedside in SAH patients?

No answer

Yes

No

43 (28%)

55 (36%)

56 (36%)

Which is the arterial blood pressure target that you use in patients before aneurism treatment?

No answer

 < 140/90

 < 160/90

185/110

Reduction of 15% of the initial arterial blood pressure

MAP-based protocols

Other

43 (28%)

47 (31%)

34 (22%)

4 (3%)

9 (6%)

11 (7%)

6 (4%)

Which is the arterial blood pressure target that you use in patients after aneurism treatment without vasospasm?

No answer

MAP + 10 mmHg compared to baseline

MAP 80 mmHg

MAP 90 mmHg

MAP 100 mmHg

Other

43 (28%)

15 (10%)

33 (21%)

37 (24%)

8 (5%)

18 (12%)

Which is the arterial blood pressure target that you use in patients in patients with vasospasm?

No answer

MAP + 10 mmHg compared to baseline

MAP 80 mmHg

MAP 90 mmHg

MAP 100 mmHg

MAP target on neurological status

Other

43 (28%)

13 (8%)

7 (5%)

10 (6%)

23 (15%)

50 (32%)

8 (5%)

Which hemodynamic monitoring do you use in case of patient with subarachnoid hemorrhage with no signs of vasospasm?

No answer

Basic monitoring (NIBP, ECG)

Basic monitoring (Invasive blood pressure, ECG)

Advanced non-invasive hemodynamic monitoring

Advanced invasive monitoring

Echocardiography

43 (28%)

18 (12%)

68 (44%)

5 (3%)

14 (9%)

6 (4%)

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)

Vasospasm

Other

Never

43 (28%)

12 (8%)

43 (28%)

73 (47%)

34 (22%)

31 (20%)

2 (1%)

3 (2%)

How do you manage hypotension in SAH patients?

No answer

Mean arterial pressure-based protocol

No specific protocol

Cardiac output-based protocol

Fluids

43 (28%)

76 (49%)

22 (14%)

7 (5%)

6 (4%)

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

No answer

Norepinephrine

Vasopressin

Dobutamine

Epinephrine

Metaraminol

43 (28%)

107 (69%)

3 (2%)

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

43 (28%)

51 (33%)

21 (14%)

21 (14%)

11 (7%)

7 (5%)

How frequently do you monitor fluid balance?

No answer

Every hour

Every 2 h

Every 4 h

Every 12 h

Every 24 h

43 (28%)

45 (29%)

21 (14%)

7 (5%)

20 (13%)

18 (12%)

Which is your net daily fluid balance target?

No answer

Negative

Neutral

Positive

43 (28%)

5 (3%)

68 (44%)

38 (25%)

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

No answer

Normal saline

Ringer lactate

Hypertonic saline

Plasmalyte

Albumin

Other

43 (28%)

46 (30%)

43 (28%)

6 (4%)

5 (3%)

1 (< 1%)

10 (6%)