MENA-Adapted Guidelines

Aneurysmal Subarachnoid Hemorrhage

Clinical Recommendations

Evidence-based recommendations adapted for MENA healthcare settings, organized by clinical domain.

Medical Complications

COR 1 LOE B-R RL
Adapted from Neurocritical Care Society

We strongly recommend implementing standardized protocols for managing fever, hyperglycemia, and hyponatremia in aSAH patients.

MENA-Specific Considerations

Protocols should be adapted for varying ICU capabilities and nursing staff ratios across MENA healthcare settings.

COR 2a LOE C
Adapted from Chinese Guidelines

We recommend early enteral nutrition within 24-48 hours to support recovery and reduce complications.

MENA-Specific Considerations

Nutritional products and feeding protocols should consider cultural dietary preferences and local availability.

COR EO-Strong LOE C RL
MENA-SINO Original

In settings with limited monitoring equipment, we strongly recommend simplified protocols for fluid management using physical examination and basic laboratory values.

MENA-Specific Considerations

Emphasizes practical approaches when advanced hemodynamic monitoring is unavailable.

Recommendation Grading System

Class of Recommendation (COR)

1 Strong recommendation - Should be performed
2a Moderate recommendation - Reasonable to perform
2b Weak recommendation - May be considered

Level of Evidence (LOE)

A High-quality evidence from multiple RCTs
B Moderate evidence from single RCT or observational studies
C Expert opinion or case studies

Special Designations

RL Resource-Limited - Requires adaptation for limited resources
EO Expert Opinion - MENA-SINO consensus recommendation