blood pressure targets (strokes, bleeds, and tears)

15 Sep

 

Adapted from an old post, but a good refresher that came up again recently, with a new little table from a recent emed journal article that includes some recommendations for BP targets in stroke (ischemic or otherwise):

neuroBP

 

(and from a previous post):

IS SOMETHING BLEEDING (OR ABOUT TO)?  MINIMIZE THE DAMAGE:

ICH:

–lowering to SBP 140-160 probably safe

–theory: less/slower hematoma growth

–options: nicardipine (less cerebral vasospasm)

 

AORTIC DISSECTION:

SBP 100-120, HR <60

–theory: reduce shear forces

–options: beta blocker (labetolol push, esmolol drip), nitroprusside

 

RUPTURED AAA:

–goal SBP 80-100

–theory: permissive hypotension; bleed slower, less likely to blow out the few clots they’re making

Reference(s): emed-journal articleuptodate.com: Ruptured abdominal aortic aneurysm, management of aortic dissection, Spontaneous intracerebral hemorrhage: Prognosis and treatment, Kodama K, et al. Tight heart rate control reduces secondary adverse events in patients with type B acute aortic dissection, picture

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