Guideline-recommended basic parameter adherence in neurocritical care stroke patients: Observational multicenter individual participant data analysis

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Anne Mrochen - , Justus Liebig University Giessen (Author)
  • Omar Alhaj Omar - , Justus Liebig University Giessen (Author)
  • Johann O Pelz - , University Hospital Leipzig (Author)
  • Dominik Michalski - , University Hospital Leipzig (Author)
  • Hermann Neugebauer - , University Hospital of Würzburg (Author)
  • Dominik Lehrieder - , University Hospital of Würzburg (Author)
  • Benjamin Knier - , Klinikum Rechts der Isar (MRI TUM) (Author)
  • Corinna Ringmaier - , University Hospital Cologne (Author)
  • Henning Stetefeld - , University Hospital Cologne (Author)
  • Silvia Schönenberger - , University Hospital Heidelberg (Author)
  • Min Chen - , University Hospital Heidelberg (Author)
  • Hauke Schneider - , Department of Neurology, University Hospital Augsburg (Author)
  • Angelika Alonso - , Universitätsmedizin Mannheim (Author)
  • Hendrik Lesch - , Universitätsmedizin Mannheim (Author)
  • Andreas Totzeck - , University Hospital Essen (Author)
  • Friedrich Erdlenbruch - , University Hospital Essen (Author)
  • Benedikt Hiller - , Justus Liebig University Giessen (Author)
  • Norma J Diel - , Justus Liebig University Giessen (Author)
  • André Worm - , Justus Liebig University Giessen (Author)
  • Christian Claudi - , Justus Liebig University Giessen (Author)
  • Stefan T Gerner - , University of Marburg (Author)
  • Hagen B Huttner - , Justus Liebig University Giessen, University of Marburg (Author)
  • Patrick Schramm - , Justus Liebig University Giessen (Author)

Abstract

INTRODUCTION: Neurocritical care patients with neurovascular disease often face poor long-term outcomes, highlighting the pivotal role of evidence-based interventions. Although International Guidelines emphasize managing basic physiological parameters like temperature, blood glucose, blood pressure, and oxygen levels, physician adherence to these targets remains uncertain. This study aimed to assess adherence to guideline-based treatment targets for basic physiological parameters in neurocritical care.

PATIENTS AND METHODS: This multicenter observational study was conducted across eight tertiary University Hospitals in Germany analyzed 474 patients requiring mechanical ventilation (between January 1st and December 31st, 2021). Adherence was defined as the rate of measurements within therapeutic ranges for systolic blood pressure (situation-adapted), mean blood pressure (MAP, 60-90 mmHg), glucose levels (80-180 mg/dl), body temperature (<37.5°C), partial arterial pressure of oxygen (PaO 2) 80-120 mmHg und partial arterial pressure of carbon dioxide (PaCO 2) 35-45 mmHg during the initial 96 h of hospitalization in 4 hour-intervals.

RESULTS: Overall, 70.7% of all measurements were within the predetermined therapeutic ranges including SBP (71.3%), temperature (68.3%), MAP (71.4%), PaO 2 (65.2%), PaCO 2 (75.0%) and blood glucose (80.7%).

DISCUSSION AND CONCLUSION: This multicenter study demonstrates adherence to guideline-based treatment targets, underscoring the high standards maintained by neurological intensive care units. Our study offers valuable insights into adherence to guideline-based treatment targets for neurocritical care patients in Germany. To improve patient care and optimize therapeutic strategies in neurovascular diseases, further research is needed to examine the impact of these adherence parameters on long-term outcomes.

Details

Original languageEnglish
Pages (from-to)504-512
Number of pages9
JournalEuropean stroke journal
Volume10
Issue number2
Publication statusPublished - 1 Jun 2025
Peer-reviewedYes

External IDs

PubMedCentral PMC11556612
Scopus 85208019099

Keywords

Keywords

  • AIS, ICH, NICU, adherence, bundle