Template:ICH Hypertension Guidelines
Revision as of 14:54, 23 May 2014 by Ostermayer (/* AHA Aneurysmal SAH BP GuidelinesBederson 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. ...)
AHA Spontaneous ICH BP Guidelines
- 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 SAH BP Guidelines
- To date, no well-controlled studies exist that answer whether blood pressure control in acute Aneurysmal Subarachnoid Hemorrhage 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, [EBQ:Evidence_Levels|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