T pa in sah
-
Upload
mqlibrary -
Category
Health & Medicine
-
view
440 -
download
3
Transcript of T pa in sah
EBS presentation 1
The use tissue plasminogen activator in Fisher grade IV SAH
Khalid Alsahli
Macquarie Neurosurgery
Evidence Based Surgery presentation
Date: 10/10/2013
EBS presentation 2
Clinical case
• Male, 6th decade, collapse, GCS 3• CT – Fisher grade IV SAH. Ruptured AcomA
EBS presentation 3
Searchable question (PICO format)
• In patients with intraventricular extension of aneurysmal subarachnoid haemorrhage, Does the use intraventricular tPA improve outcomes?
• P: Patients with intraventricular extension of aneurysmal subarachnoid haemorrhage.
• I: Intraventricular tPA.
• C:
• O: Treatment outcomes
EBS presentation 4
Search strategy
• Medline, Embase, Scopus
EBS presentation 5
Medline
EBS presentation 6
Medline – Mary’s edition
EBS presentation 7
Embase
EBS presentation 8
Embase
EBS presentation 9
Embase – Mary’s edition
EBS presentation 10
Scopus
EBS presentation 11
Search cont.
• Excluded case reports, unrelated topics.• 7 articles were identified• 3 were excluded – included patients with ICH
and non-aneurysmal SAH.
EBS presentation 12
Summary of papers
• Excel table
EBS presentation 13
Conclusions
• tPA accelerates intraventricular clot resolution.
• Not enough evidence to support its usage to improve outcomes.
• Few studies, need multicenter RCTs studies with larger sample size.