22501_BEST PRACTICES FOR MANAGING INTRACEREBRAL HEMORRHAGE

In this symposium, experts in ICH management will discuss the clinical evidence for blood pressure control and DOAC reversal and provide illustrative case studies. Results of studies focusing on bundles of care will be summarized, and faculty members will provide insights for an adoption of this strategy to improve patient outcomes.

Intracerebral hemorrhage (ICH) is the most serious and least treatable form of stroke and accounts for approximately 20% of the almost 20 million new strokes that occur globally each year. Emerging evidence suggests that a number of interventions, performed early and in parallel, may improve long-term outcome. A central component of management is to provide treatment to lower blood pressure. Elevated blood pressure is common after the onset of ICH and is strongly associated with a poor outcome, and lowering towards a systolic blood pressure (SBP) of 140 mm Hg or less improves neurologic outcome. In addition to achieving goal blood pressure, smooth reduction in blood pressure without large variability is a critical element of treatment. Rapid reversal of anticoagulation in ICH patients is fundamental to improve outcome. Specific agents that reverse direct oral anticoagulants (DOACs) have demonstrated effectiveness in clinical trials and are now preferred therapies versus nonspecific agents in guidelines. Care bundles, with a focus on blood pressure management and reversal of anticoagulation, have demonstrated effectiveness and safety in improving patient outcome. Therefore, in the symposium, experts in ICH management will discuss the clinical evidence for blood pressure control and DOAC reversal and provide illustrative case studies. Results of studies focusing on bundles of care will be summarized, and faculty members will provide insights for an adoption of this strategy to improve patient outcomes.

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