Prasanna Nadarajah, Dissanayake Harsha A, Constantine Godwin R
Emergency Medicine, Post Graduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka.
University Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
BMC Res Notes. 2018 Jun 5;11(1):355. doi: 10.1186/s13104-018-3460-0.
Hypertensive emergencies are potentially life threatening and require prompt blood pressure control with intravenous agents. Preparation of intravenous infusions is time consuming. Usefulness of sublingual nitroglycerin in this setting is not known. We aimed to assess the benefit of sublingual nitroglycerin as a bridge to IV therapy. In a clinical audit in an emergency department, patients presenting with hypertensive emergencies requiring intravenous nitroglycerin were administered single spray of sublingual nitroglycerin awaiting commencement of intravenous infusion. Blood pressure was monitored every 5 min to observe the degree and speed of reduction.
Thirty-seven patients met the selection criteria. Mean age was 65.8 years (SD 7.04), and 29 were males (88.4%). Mean values of systolic, diastolic and mean blood pressures on admission were 217, 137, 163 mmHg. At 5 and 10 min after sublingual nitroglycerin, mean reduction of mean arterial blood pressure by 12.3 and 16.3% was achieved. Only 2 patients (5.4%) showed an overcorrection of blood pressure. Minimum of 15 min were required to set up a nitroglycerin intravenous infusion. Sublingual nitroglycerin spray allows rapid blood pressure control in hypertensive emergencies and is a useful bridge during the time to prepare intravenous infusion.
高血压急症可能危及生命，需要使用静脉药物迅速控制血压。准备静脉输注耗时较长。舌下含服硝酸甘油在此种情况下的有效性尚不清楚。我们旨在评估舌下含服硝酸甘油作为过渡到静脉治疗的桥梁的益处。在一家急诊科的临床审计中，对于出现高血压急症且需要静脉输注硝酸甘油的患者，在等待开始静脉输注期间给予单次舌下含服硝酸甘油喷雾。每5分钟监测一次血压，以观察血压降低的程度和速度。
37例患者符合入选标准。平均年龄为65.8岁（标准差7.04），男性29例（88.4%）。入院时收缩压、舒张压和平均血压的平均值分别为217、137、163 mmHg。舌下含服硝酸甘油后5分钟和10分钟时，平均动脉血压分别平均降低了12.3%和16.3%。仅2例患者（5.4%）出现血压过度纠正。准备硝酸甘油静脉输注最少需要15分钟。舌下含服硝酸甘油喷雾可在高血压急症中迅速控制血压，并且在准备静脉输注的这段时间内是一种有用的过渡措施。
