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Status: Bibliographieeintrag

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Verfasst von:Schönenberger, Silvia [VerfasserIn]   i
 Kronsteiner, Dorothea [VerfasserIn]   i
 Ungerer, Matthias [VerfasserIn]   i
 Pfaff, Johannes [VerfasserIn]   i
 Schieber, Simon [VerfasserIn]   i
 Uhlmann, Lorenz [VerfasserIn]   i
 Heidenreich, Pia [VerfasserIn]   i
 Bendszus, Martin [VerfasserIn]   i
 Kieser, Meinhard [VerfasserIn]   i
 Wick, Wolfgang [VerfasserIn]   i
 Möhlenbruch, Markus Alfred [VerfasserIn]   i
 Ringleb, Peter A. [VerfasserIn]   i
 Bösel, Julian [VerfasserIn]   i
Titel:The KEEP SIMPLEST study
Titelzusatz:improving in-house delays and periinterventional management in stroke thrombectomy; a matched pair analysis
Verf.angabe:Silvia Schönenberger, Dorothea Weber, Matthias N. Ungerer, Johannes Pfaff, Simon Schieber, Lorenz Uhlmann, Pia Heidenreich, Martin Bendszus, Meinhard Kieser, Wolfgang Wick, Markus A. Möhlenbruch, Peter A. Ringleb, Julian Bösel
E-Jahr:2019
Jahr:18 January 2019
Umfang:10 S.
Fussnoten:Gesehen am 05.08.2019
Titel Quelle:Enthalten in: Neurocritical care
Ort Quelle:New York, NY : Springer, 2004
Jahr Quelle:2019
Band/Heft Quelle:31(2019), 1, Seite 46-55
ISSN Quelle:1556-0961
Abstract:Background and Purpose: Although the treatment window for mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) has been extended in recent years, it has been proven that recanalizing treatment must be administered as soon as possible. We present a new standard operating procedure (SOP) to reduce in-house delay, standardize periinterventional management and improve patient safety during MT. MethodsKEep Evaluating Protocol Simplification In Managing Periinterventional Light Sedation for Endovascular Stroke Treatment (KEEP SIMPLEST) was a prospective, single-center observational study aimed to compare aspects of periinterventional management in AIS patients treated according to our new SOP using a combination of esketamine and propofol with patients having been randomized into conscious sedation (CS) in the Sedation versus Intubation for Endovascular Stroke TreAtment (SIESTA) trial. Primary outcome was early neurological improvement at 24h using the National Institutes of Health Stroke Scale, and secondary outcomes were door-to-recanalization, recanalization grade, conversion rate and modified Rankin Scale (mRS) at 3 months.ResultsDoor-to-recanalization time (128.6 ± 69.47 min vs. 156.8 ± 75.91 min; p = 0.02), mean duration of MT (92.01 ± 52 min vs. 131.9 ± 64.03 min; p < 0.001), door-to-first angiographic image (51.61 ± 31.7 min vs. 64.23 ± 21.53 min; p = 0.003) and computed tomography-to-first angiographic image time (31.61 ± 20.6 min vs. 44.61 ± 19.3 min; p < 0.001) were significantly shorter in the group treated under the new SOP. There were no differences in early neurological improvement, mRS at 3 months or other secondary outcomes between the groups. Conversion rates of CS to general anesthesia were similar in both groups.ConclusionAn SOP using a novel sedation regimen and optimization of equipment and procedures directed at a leaner, more integrative and compact periinterventional management can reduce in-house treatment delays significantly in stroke patients receiving thrombectomy in light sedation and demonstrated the safety and feasibility of our improved approach.
DOI:doi:10.1007/s12028-018-00667-3
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1007/s12028-018-00667-3
 DOI: https://doi.org/10.1007/s12028-018-00667-3
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Blood pressure
 Conscious sedation
 Endovascular stroke treatment
 General anesthesia
 Thrombectomy
 Workflow
K10plus-PPN:1670586723
Verknüpfungen:→ Zeitschrift

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