Code-ICH: time is brain

doi:10.1097/MCC.0000000000001244

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Code-ICH: time is brain

2025-01-30

PRE

Aleksandra Yakhkind *

Wenzheng Yu

Joshua N. Goldstein

Stephan A. Mayer

DOI：10.1097/MCC.0000000000001244

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Abstract

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Purpose of reviewIntracerebral hemorrhage (ICH) is the most devastating type of stroke resulting in severe disability and mortality. This review summarizes the emerging body of evidence supporting a new paradigm for care of patients called Code-ICH. It highlights the need for the adoption of time-based care bundles based on recent evidence, akin to those used in the management of acute ischemic stroke.Recent findingsNumerous trials aimed at decreasing hematoma expansion through single interventions have historically failed to show significant effects on primary outcomes. Time-sensitive, multifaceted, bundled care approaches have emerged with substantial promise in improving functional outcomes in patients with ICH. These bundles include early aggressive control of blood pressure and reversal of anticoagulation, strict normalization of blood sugar and temperature, early surgical evaluation, and minimizing early withdrawal of care.SummaryThe paradigm of Code-ICH empowers acute care providers to continuously measure system performance, reflect on best practices, improve outcomes, and tackle disparities for patients with ICH.

Keywords:

acute care neurology

bundled care

hematoma expansion

hemostasis control

intracerebral hemorrhage

Journal

Current Opinion in Critical Care

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3.4

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1.9K

Citations:

3.8K

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tufts university

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Harvard University

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harvard university medical affiliates

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