Template:ICH Hypertension Guidelines: Difference between revisions
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Ostermayer (talk | contribs) (/* AHA Spontaneous ICH Blood Pressure GuidelinesMorgenstern, L. et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association Strok...) |
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===AHA Spontaneous ICH | ===AHA Spontaneous ICH BP Guidelines<ref>Morgenstern, L. et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association Stroke 2010;41;2108-2129 [http://bit.ly/ahaichguide PDF]</ref>=== | ||
#If SBP is >200 mm Hg or MAP is >150 mm Hg, then consider aggressive reduction of BP with continuous intravenous infusion, with frequent BP monitoring every 5 min. | #If SBP is >200 mm Hg or MAP is >150 mm Hg, then consider aggressive reduction of BP with continuous intravenous infusion, with frequent BP monitoring every 5 min. | ||
#If SBP is >180 mmHg or MAP is >130mm Hg and there is the possibility of elevated ICP, then consider monitoring ICP and reducing BP using intermittent or continuous intravenous medications while maintaining a cerebral perfusion pressure ≥60 mm Hg | #If SBP is >180 mmHg or MAP is >130mm Hg and there is the possibility of elevated ICP, then consider monitoring ICP and reducing BP using intermittent or continuous intravenous medications while maintaining a cerebral perfusion pressure ≥60 mm Hg | ||
#If SBP is >180 mmHg or MAP is >130 mmHg and there is not evidence of elevated ICP, then consider a modest reduction of BP '''(eg, MAP of 110 mm Hg or target BP of 160/90 mm Hg)''' using intermittent or continuous intravenous medications to control BP and clinically reexamine the patient every 15 min | #If SBP is >180 mmHg or MAP is >130 mmHg and there is not evidence of elevated ICP, then consider a modest reduction of BP '''(eg, MAP of 110 mm Hg or target BP of 160/90 mm Hg)''' using intermittent or continuous intravenous medications to control BP and clinically reexamine the patient every 15 min | ||
===AHA Aneurysmal Subarachnoid Hemorrhage BP Guidelines<ref>Bederson J. et al. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association. Stroke. 2009;40:994-1025 [http://stroke.ahajournals.org/content/40/3/994.full.pdf PDF]</ref>=== | |||
#To date, no well-controlled studies exist that answer whether blood pressure control in acute SAH influences rebreeding. | |||
#Blood pressure should be monitored and controlled to balance the risk of stroke, hypertension-related rebleeding, and maintenance of cerebral perfusion pressure (Class I, Level of Evidence B). | |||
#Nicardipine, labetalol, and esmolol are appropriate choices for blood pressure control. Sodium nitroprusside may raise intracranial pressure and cause toxicity with prolonged infusion and should be avoided. | |||
Revision as of 15:17, 15 May 2014
AHA Spontaneous ICH BP Guidelines[1]
- If SBP is >200 mm Hg or MAP is >150 mm Hg, then consider aggressive reduction of BP with continuous intravenous infusion, with frequent BP monitoring every 5 min.
- If SBP is >180 mmHg or MAP is >130mm Hg and there is the possibility of elevated ICP, then consider monitoring ICP and reducing BP using intermittent or continuous intravenous medications while maintaining a cerebral perfusion pressure ≥60 mm Hg
- If SBP is >180 mmHg or MAP is >130 mmHg and there is not evidence of elevated ICP, then consider a modest reduction of BP (eg, MAP of 110 mm Hg or target BP of 160/90 mm Hg) using intermittent or continuous intravenous medications to control BP and clinically reexamine the patient every 15 min
AHA Aneurysmal Subarachnoid Hemorrhage BP Guidelines[2]
- To date, no well-controlled studies exist that answer whether blood pressure control in acute SAH influences rebreeding.
- Blood pressure should be monitored and controlled to balance the risk of stroke, hypertension-related rebleeding, and maintenance of cerebral perfusion pressure (Class I, Level of Evidence B).
- Nicardipine, labetalol, and esmolol are appropriate choices for blood pressure control. Sodium nitroprusside may raise intracranial pressure and cause toxicity with prolonged infusion and should be avoided.
- ↑ Morgenstern, L. et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association Stroke 2010;41;2108-2129 PDF
- ↑ Bederson J. et al. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association. Stroke. 2009;40:994-1025 PDF