Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations

Mauro Oddo; Daniele Poole; Raimund Helbok; Geert Meyfroidt; Nino Stocchetti; Pierre Bouzat; Maurizio Cecconi; Thomas Geeraerts; Ignacio Martin-Loeches; Hervé Quintard; Fabio Silvio Taccone; Romergryko G. Geocadin; Claude Hemphill; Carole Ichai; David Menon; Jean François Payen; Anders Perner; Martin Smith; José Suarez; Walter Videtta; Elisa R. Zanier; Giuseppe Citerio

doi:10.1007/s00134-018-5086-z

Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations

Mauro Oddo^*, Daniele Poole, Raimund Helbok, Geert Meyfroidt, Nino Stocchetti, Pierre Bouzat, Maurizio Cecconi, Thomas Geeraerts, Ignacio Martin-Loeches, Hervé Quintard, Fabio Silvio Taccone, Romergryko G. Geocadin, Claude Hemphill, Carole Ichai, David Menon, Jean François Payen, Anders Perner, Martin Smith, José Suarez, Walter VidettaElisa R. Zanier, Giuseppe Citerio

^*Corresponding author for this work

Department of Clinical Medicine

37 Citations (Scopus)

Abstract

Objective: To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients. Design: A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. Methods: Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles generated. The consensus focused on three main topics: (1) general fluid resuscitation and maintenance in neurointensive care patients, (2) hyperosmolar fluids for intracranial pressure control, (3) fluid management in delayed cerebral ischemia after subarachnoid haemorrhage. After an extensive literature search, the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were applied to assess the quality of evidence (from high to very low), to formulate treatment recommendations as strong or weak, and to issue best practice statements when applicable. A modified Delphi process based on the integration of evidence provided by the literature and expert opinions—using a sequential approach to avoid biases and misinterpretations—was used to generate the final consensus statement. Results: The final consensus comprises a total of 32 statements, including 13 strong recommendations and 17 weak recommendations. No recommendations were provided for two statements. Conclusions: We present a consensus statement and clinical practice recommendations on fluid therapy for neurointensive care patients.

Original language	English
Journal	Intensive Care Medicine
Volume	44
Issue number	4
Pages (from-to)	449-463
Number of pages	15
ISSN	0342-4642
DOIs	https://doi.org/10.1007/s00134-018-5086-z
Publication status	Published - 2018

Keywords

Evidence‐based medicine
Fluid therapy
Guidelines
Hypertonic
Intracerebral haemorrhage
Mannitol
Neurointensive care
Stroke
Subarachnoid haemorrhage
Traumatic brain injury

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Oddo, M., Poole, D., Helbok, R., Meyfroidt, G., Stocchetti, N., Bouzat, P., Cecconi, M., Geeraerts, T., Martin-Loeches, I., Quintard, H., Taccone, F. S., Geocadin, R. G., Hemphill, C., Ichai, C., Menon, D., Payen, J. F., Perner, A., Smith, M., Suarez, J., ... Citerio, G. (2018). Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations. Intensive Care Medicine, 44(4), 449-463. https://doi.org/10.1007/s00134-018-5086-z

Oddo, M, Poole, D, Helbok, R, Meyfroidt, G, Stocchetti, N, Bouzat, P, Cecconi, M, Geeraerts, T, Martin-Loeches, I, Quintard, H, Taccone, FS, Geocadin, RG, Hemphill, C, Ichai, C, Menon, D, Payen, JF, Perner, A, Smith, M, Suarez, J, Videtta, W, Zanier, ER & Citerio, G 2018, 'Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations', Intensive Care Medicine, vol. 44, no. 4, pp. 449-463. https://doi.org/10.1007/s00134-018-5086-z

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title = "Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations",

abstract = "Objective: To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients. Design: A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. Methods: Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles generated. The consensus focused on three main topics: (1) general fluid resuscitation and maintenance in neurointensive care patients, (2) hyperosmolar fluids for intracranial pressure control, (3) fluid management in delayed cerebral ischemia after subarachnoid haemorrhage. After an extensive literature search, the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were applied to assess the quality of evidence (from high to very low), to formulate treatment recommendations as strong or weak, and to issue best practice statements when applicable. A modified Delphi process based on the integration of evidence provided by the literature and expert opinions—using a sequential approach to avoid biases and misinterpretations—was used to generate the final consensus statement. Results: The final consensus comprises a total of 32 statements, including 13 strong recommendations and 17 weak recommendations. No recommendations were provided for two statements. Conclusions: We present a consensus statement and clinical practice recommendations on fluid therapy for neurointensive care patients.",

keywords = "Evidence‐based medicine, Fluid therapy, Guidelines, Hypertonic, Intracerebral haemorrhage, Mannitol, Neurointensive care, Stroke, Subarachnoid haemorrhage, Traumatic brain injury",

author = "Mauro Oddo and Daniele Poole and Raimund Helbok and Geert Meyfroidt and Nino Stocchetti and Pierre Bouzat and Maurizio Cecconi and Thomas Geeraerts and Ignacio Martin-Loeches and Herv{\'e} Quintard and Taccone, {Fabio Silvio} and Geocadin, {Romergryko G.} and Claude Hemphill and Carole Ichai and David Menon and Payen, {Jean Fran{\c c}ois} and Anders Perner and Martin Smith and Jos{\'e} Suarez and Walter Videtta and Zanier, {Elisa R.} and Giuseppe Citerio",

year = "2018",

doi = "10.1007/s00134-018-5086-z",

language = "English",

volume = "44",

pages = "449--463",

journal = "European Journal of Intensive Care Medicine",

issn = "0935-1701",

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TY - JOUR

T1 - Fluid therapy in neurointensive care patients

T2 - ESICM consensus and clinical practice recommendations

AU - Oddo, Mauro

AU - Poole, Daniele

AU - Helbok, Raimund

AU - Meyfroidt, Geert

AU - Stocchetti, Nino

AU - Bouzat, Pierre

AU - Cecconi, Maurizio

AU - Geeraerts, Thomas

AU - Martin-Loeches, Ignacio

AU - Quintard, Hervé

AU - Taccone, Fabio Silvio

AU - Geocadin, Romergryko G.

AU - Hemphill, Claude

AU - Ichai, Carole

AU - Menon, David

AU - Payen, Jean François

AU - Perner, Anders

AU - Smith, Martin

AU - Suarez, José

AU - Videtta, Walter

AU - Zanier, Elisa R.

AU - Citerio, Giuseppe

PY - 2018

Y1 - 2018

N2 - Objective: To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients. Design: A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. Methods: Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles generated. The consensus focused on three main topics: (1) general fluid resuscitation and maintenance in neurointensive care patients, (2) hyperosmolar fluids for intracranial pressure control, (3) fluid management in delayed cerebral ischemia after subarachnoid haemorrhage. After an extensive literature search, the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were applied to assess the quality of evidence (from high to very low), to formulate treatment recommendations as strong or weak, and to issue best practice statements when applicable. A modified Delphi process based on the integration of evidence provided by the literature and expert opinions—using a sequential approach to avoid biases and misinterpretations—was used to generate the final consensus statement. Results: The final consensus comprises a total of 32 statements, including 13 strong recommendations and 17 weak recommendations. No recommendations were provided for two statements. Conclusions: We present a consensus statement and clinical practice recommendations on fluid therapy for neurointensive care patients.

AB - Objective: To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients. Design: A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. Methods: Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles generated. The consensus focused on three main topics: (1) general fluid resuscitation and maintenance in neurointensive care patients, (2) hyperosmolar fluids for intracranial pressure control, (3) fluid management in delayed cerebral ischemia after subarachnoid haemorrhage. After an extensive literature search, the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were applied to assess the quality of evidence (from high to very low), to formulate treatment recommendations as strong or weak, and to issue best practice statements when applicable. A modified Delphi process based on the integration of evidence provided by the literature and expert opinions—using a sequential approach to avoid biases and misinterpretations—was used to generate the final consensus statement. Results: The final consensus comprises a total of 32 statements, including 13 strong recommendations and 17 weak recommendations. No recommendations were provided for two statements. Conclusions: We present a consensus statement and clinical practice recommendations on fluid therapy for neurointensive care patients.

KW - Evidence‐based medicine

KW - Fluid therapy

KW - Guidelines

KW - Hypertonic

KW - Intracerebral haemorrhage

KW - Mannitol

KW - Neurointensive care

KW - Stroke

KW - Subarachnoid haemorrhage

KW - Traumatic brain injury

U2 - 10.1007/s00134-018-5086-z

DO - 10.1007/s00134-018-5086-z

M3 - Journal article

C2 - 29500701

AN - SCOPUS:85044974826

SN - 0935-1701

VL - 44

SP - 449

EP - 463

JO - European Journal of Intensive Care Medicine

JF - European Journal of Intensive Care Medicine

IS - 4

ER -

Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations

Abstract

Keywords

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