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Published on: October 15, 2021
Acute care bundles should be used for patients with intracerebral haemorrhage: An expert consensus statement
Adrian R Parry-Jones1, Susann J Järhult2, Natalie Kreitzer3
1Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK.
Insights
Implementing formalised care bundles for intracerebral haemorrhage (ICH) can significantly reduce patient morbidity and mortality. Widespread adoption of these bundled interventions is crucial for improving outcomes in acute stroke care.
Area of Science:
- Neurology
- Stroke Medicine
- Critical Care
Background:
- Intracerebral haemorrhage (ICH) is a severe stroke type, leading to significant disability.
- Individual ICH therapies have shown limited success in clinical trials.
- Care bundles, combining multiple treatments, demonstrate potential to reduce ICH morbidity and mortality.
Purpose of the Study:
- To discuss best practices for managing acute intracerebral haemorrhage.
- To develop recommendations for implementing care bundles in European healthcare systems.
- To advocate for the widespread adoption of formalised care bundles in ICH management.
Main Methods:
- Convened an expert group to discuss intracerebral haemorrhage (ICH) best practices.
- Developed recommendations for bundled care applicable to all acute ICH treatment settings.
- Focused on European healthcare systems for implementation strategies.
Main Results:
- Argues for the widespread implementation of formalised care bundles in intracerebral haemorrhage (ICH).
- Includes specific metrics for timely treatment initiation.
- Provides criteria for considering neurosurgical interventions.
Conclusions:
- There is a significant opportunity to improve clinical care and outcomes for intracerebral haemorrhage (ICH).
- Existing evidence supports the immediate implementation of various therapies.
- Formalised care bundles represent a key strategy for enhancing acute ICH management.
Purpose:
Intracerebral haemorrhage (ICH) is the most devastating form of stroke and a major cause of disability. Clinical trials of individual therapies have failed to definitively establish a specific beneficial treatment. However, clinical trials of introducing care bundles, with multiple therapies provided in parallel, appear to clearly reduce morbidity and mortality. Currently, not enough patients receive these interventions in the acute phase.
Methods:
We convened an expert group to discuss best practices in ICH and to develop recommendations for bundled care that can be delivered in all settings that treat acute ICH, with a focus on European healthcare systems.
Findings:
In this consensus paper, we argue for widespread implementation of formalised care bundles in ICH, including specific metrics for time to treatment and criteria for the consideration of neurosurgical therapy.
Discussion:
There is an extraordinary opportunity to improve clinical care and clinical outcomes in this devastating disease. Substantial evidence already exists for a range of therapies that can and should be implemented now.
