Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage
Un protocolo de manejo institucional para pacientes con hemorragia subaracnoidea (HSA) basado en la evaluación cardíaca inicial, la permisividad de los balances negativos de líquidos y el uso de una infusión continua de albúmina como fluidoterapia principal durante los primeros 5 días de estancia en...
- Autores:
-
Gempeler, Andrés
Gaviria, Leidy
Ortiz, Alejandra
Jaramillo, Natalia
Beltrán, Luis
Escobar, Sara
Rondón, Martín
Rosselli, Diego
Martinez-Buitrago, Jorge E.
Mejía-Mantilla, Jorge H.
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2023
- Institución:
- Pontificia Universidad Javeriana
- Repositorio:
- Repositorio Universidad Javeriana
- Idioma:
- eng
- OAI Identifier:
- oai:repository.javeriana.edu.co:10554/65903
- Acceso en línea:
- https://link.springer.com/article/10.1007/s12028-023-01731-3
http://hdl.handle.net/10554/65903
https://doi.org/10.1007/s12028-023-01731-3
- Palabra clave:
- Hemorragia subaracnoidea
Subarachnoid Hemorrhage
- Rights
- License
- Atribución-NoComercial 4.0 Internacional
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| dc.title.spa.fl_str_mv |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage |
| title |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage |
| spellingShingle |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage Hemorragia subaracnoidea Subarachnoid Hemorrhage |
| title_short |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage |
| title_full |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage |
| title_fullStr |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage |
| title_full_unstemmed |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage |
| title_sort |
Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage |
| dc.creator.fl_str_mv |
Gempeler, Andrés Gaviria, Leidy Ortiz, Alejandra Jaramillo, Natalia Beltrán, Luis Escobar, Sara Rondón, Martín Rosselli, Diego Martinez-Buitrago, Jorge E. Mejía-Mantilla, Jorge H. |
| dc.contributor.author.none.fl_str_mv |
Gempeler, Andrés Gaviria, Leidy Ortiz, Alejandra Jaramillo, Natalia Beltrán, Luis Escobar, Sara Rondón, Martín Rosselli, Diego Martinez-Buitrago, Jorge E. Mejía-Mantilla, Jorge H. |
| dc.contributor.corporatename.spa.fl_str_mv |
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística |
| dc.subject.spa.fl_str_mv |
Hemorragia subaracnoidea |
| topic |
Hemorragia subaracnoidea Subarachnoid Hemorrhage |
| dc.subject.keyword.spa.fl_str_mv |
Subarachnoid Hemorrhage |
| description |
Un protocolo de manejo institucional para pacientes con hemorragia subaracnoidea (HSA) basado en la evaluación cardíaca inicial, la permisividad de los balances negativos de líquidos y el uso de una infusión continua de albúmina como fluidoterapia principal durante los primeros 5 días de estancia en la unidad de cuidados intensivos (UCI). se implementó en nuestro hospital en 2014. Tenía como objetivo lograr y mantener la euvolemia y la estabilidad hemodinámica para prevenir eventos isquémicos y complicaciones en la UCI reduciendo los períodos de hipovolemia o inestabilidad hemodinámica. Este estudio tuvo como objetivo evaluar el efecto del protocolo de manejo implementado sobre la incidencia de isquemia cerebral retardada (ICD), la mortalidad y otros resultados relevantes en pacientes con HSA durante la estancia en la UCI. |
| publishDate |
2023 |
| dc.date.created.none.fl_str_mv |
2023-05-25 |
| dc.date.accessioned.none.fl_str_mv |
2024-01-04T20:42:31Z |
| dc.date.available.none.fl_str_mv |
2024-01-04T20:42:31Z |
| dc.type.local.spa.fl_str_mv |
Artículo de revista |
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http://purl.org/coar/resource_type/c_2df8fbb1 |
| format |
http://purl.org/coar/resource_type/c_2df8fbb1 |
| dc.identifier.spa.fl_str_mv |
https://link.springer.com/article/10.1007/s12028-023-01731-3 |
| dc.identifier.issn.spa.fl_str_mv |
15560961 |
| dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/10554/65903 |
| dc.identifier.doi.spa.fl_str_mv |
https://doi.org/10.1007/s12028-023-01731-3 |
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instname:Pontificia Universidad Javeriana |
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reponame:Repositorio Institucional - Pontificia Universidad Javeriana |
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repourl:https://repository.javeriana.edu.co |
| url |
https://link.springer.com/article/10.1007/s12028-023-01731-3 http://hdl.handle.net/10554/65903 https://doi.org/10.1007/s12028-023-01731-3 |
| identifier_str_mv |
15560961 instname:Pontificia Universidad Javeriana reponame:Repositorio Institucional - Pontificia Universidad Javeriana repourl:https://repository.javeriana.edu.co |
| dc.language.iso.spa.fl_str_mv |
eng |
| language |
eng |
| dc.relation.citationstartpage.spa.fl_str_mv |
180 |
| dc.relation.citationendpage.spa.fl_str_mv |
190 |
| dc.relation.ispartofjournal.spa.fl_str_mv |
Neurocritical Care |
| dc.relation.citationissue.spa.fl_str_mv |
39 |
| dc.rights.licence.*.fl_str_mv |
Atribución-NoComercial 4.0 Internacional |
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http://creativecommons.org/licenses/by-nc/4.0/ |
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http://purl.org/coar/access_right/c_abf2 |
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Atribución-NoComercial 4.0 Internacional http://creativecommons.org/licenses/by-nc/4.0/ http://purl.org/coar/access_right/c_abf2 |
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PDF |
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application/pdf |
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Pontificia Universidad Javeriana |
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Atribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/http://purl.org/coar/access_right/c_abf2Gempeler, AndrésGaviria, LeidyOrtiz, AlejandraJaramillo, NataliaBeltrán, LuisEscobar, SaraRondón, MartínRosselli, DiegoMartinez-Buitrago, Jorge E.Mejía-Mantilla, Jorge H.Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística2024-01-04T20:42:31Z2024-01-04T20:42:31Z2023-05-25https://link.springer.com/article/10.1007/s12028-023-01731-315560961http://hdl.handle.net/10554/65903https://doi.org/10.1007/s12028-023-01731-3instname:Pontificia Universidad Javerianareponame:Repositorio Institucional - Pontificia Universidad Javerianarepourl:https://repository.javeriana.edu.coUn protocolo de manejo institucional para pacientes con hemorragia subaracnoidea (HSA) basado en la evaluación cardíaca inicial, la permisividad de los balances negativos de líquidos y el uso de una infusión continua de albúmina como fluidoterapia principal durante los primeros 5 días de estancia en la unidad de cuidados intensivos (UCI). se implementó en nuestro hospital en 2014. Tenía como objetivo lograr y mantener la euvolemia y la estabilidad hemodinámica para prevenir eventos isquémicos y complicaciones en la UCI reduciendo los períodos de hipovolemia o inestabilidad hemodinámica. Este estudio tuvo como objetivo evaluar el efecto del protocolo de manejo implementado sobre la incidencia de isquemia cerebral retardada (ICD), la mortalidad y otros resultados relevantes en pacientes con HSA durante la estancia en la UCI.Q1Background An institutional management protocol for patients with subarachnoid hemorrhage (SAH) based on initial cardiac assessment, permissiveness of negative fluid balances, and use of a continuous albumin infusion as the main fluid therapy for the first 5 days of the intensive care unit (ICU) stay was implemented at our hospital in 2014. It aimed at achieving and maintaining euvolemia and hemodynamic stability to prevent ischemic events and complications in the ICU by reducing periods of hypovolemia or hemodynamic instability. This study aimed at assessing the effect of the implemented management protocol on the incidence of delayed cerebral ischemia (DCI), mortality, and other relevant outcomes in patients with SAH during ICU stay. Methods We conducted a quasi-experimental study with historical controls based on electronic medical records of adults with SAH admitted to the ICU at a tertiary care university hospital in Cali, Colombia. The patients treated between 2011 and 2014 were the control group, and those treated between 2014 and 2018 were the intervention group. We collected baseline clinical characteristics, cointerventions, occurrence of DCI, vital status after 6 months, neurological status after 6 months, hydroelectrolytic imbalances, and other SAH complication. Multivariable and sensitivity analyses that controlled for confounding and considered the presence of competing risks were used to adequately estimate the effects of the management protocol. The study was approved by our institutional ethics review board before study start. Results One hundred eighty-nine patients were included for analysis. The management protocol was associated with a reduced incidence of DCI (hazard ratio 0.52 [95% confidence interval 0.33–0.83] from multivariable subdistribution hazards model) and hyponatremia (relative risk 0.55 [95% confidence interval 0.37–0.80]). The management protocol was not associated with higher hospital or long-term mortality, nor with a higher occurrence of other unfavorable outcomes (pulmonary edema, rebleeding, hydrocephalus, hypernatremia, pneumonia). The intervention group also had lower daily and cumulative administered fluids compared with historic controls (p < 0.0001). Conclusions A management protocol based on hemodynamically oriented fluid therapy in combination with a continuous albumin infusion as the main fluid during the first 5 days of the ICU stay appears beneficial for patients with SAH because it was associated with reduced incidence of DCI and hyponatremia. Proposed mechanisms include improved hemodynamic stability that allows euvolemia and reduces the risk of ischemia, among others.Revista Internacional - IndexadaSiPDFapplication/pdfengHemorragia subaracnoideaSubarachnoid HemorrhageEffect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid HemorrhageArtículo de revistahttp://purl.org/coar/resource_type/c_2df8fbb1180190Neurocritical Care39ORIGINALEffect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage.pdfEffect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage.pdfArtículoapplication/pdf740738http://repository.javeriana.edu.co/bitstream/10554/65903/1/Effect%20of%20an%20Albumin%20Infusion%20Treatment%20Protocol%20on%20Delayed%20Cerebral%20Ischemia%20and%20Relevant%20Outcomes%20in%20Patients%20with%20Subarachnoid%20Hemorrhage.pdf2055b91698bfeba67513f616268a9d27MD51open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-82603http://repository.javeriana.edu.co/bitstream/10554/65903/2/license.txt2070d280cc89439d983d9eee1b17df53MD52open accessTHUMBNAILEffect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage.pdf.jpgEffect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage.pdf.jpgIM Thumbnailimage/jpeg9343http://repository.javeriana.edu.co/bitstream/10554/65903/3/Effect%20of%20an%20Albumin%20Infusion%20Treatment%20Protocol%20on%20Delayed%20Cerebral%20Ischemia%20and%20Relevant%20Outcomes%20in%20Patients%20with%20Subarachnoid%20Hemorrhage.pdf.jpg4bcd5c56f6807ac3f6ee62c9f11fd1e0MD53open access10554/65903oai:repository.javeriana.edu.co:10554/659032024-01-05 03:07:43.705Repositorio Institucional - Pontificia Universidad Javerianarepositorio@javeriana.edu.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 |