Neurology and Neurosurgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
J Intensive Care Med. 2013 Nov-Dec;28(6):341-54. doi: 10.1177/0885066611434100. Epub 2012 Feb 11.
Aneurysmal subarachnoid hemorrhage (SAH) has very high morbidity and mortality rates. Optimal intensive care unit (ICU) management requires knowledge of the potential complications that occur in this patient population.
Review of the ICU management of SAH. Level of evidence for specific recommendations is provided.
Grading scales utilizing clinical factors and brain imaging studies can help in determining prognosis and are reviewed. Misdiagnosis of SAH is fairly common so the clinical symptoms and signs of SAH are summarized. The ICU management of SAH is discussed beginning with a focus on avoiding aneurysm re-rupture and securing the aneurysm, followed by a review of the neurologic and medical complications that may occur after the aneurysm is secured. Detailed treatment strategies and areas of current and future research are reviewed.
The ICU management of the patient with SAH can be particularly challenging and requires an awareness of all potential neurologic and medical complications and their urgent treatments.
颅内动脉瘤性蛛网膜下腔出血（SAH）的发病率和死亡率都非常高。优化重症监护病房（ICU）管理需要了解此类患者群体中可能出现的潜在并发症。
对 SAH 的 ICU 管理进行综述。对特定建议的证据水平进行了说明。
利用临床因素和脑部影像学研究的分级量表有助于判断预后，并对此进行了综述。SAH 的误诊较为常见，因此总结了 SAH 的临床症状和体征。从避免动脉瘤再破裂和夹闭动脉瘤开始，对 SAH 的 ICU 管理进行了讨论，接着综述了动脉瘤夹闭后可能出现的神经和医学并发症。详细的治疗策略和当前及未来的研究领域也进行了综述。
SAH 患者的 ICU 管理可能特别具有挑战性，需要了解所有潜在的神经和医学并发症及其紧急治疗措施。
