Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York.
Tufts Medical Center, Boston, Massachusetts.
Pharmacotherapy. 2019 Mar;39(3):335-345. doi: 10.1002/phar.2233. Epub 2019 Mar 11.
Optimal blood pressure (BP) management is controversial in neurocritically ill patients due to conflicting concerns of worsening ischemia with decreased BP versus cerebral edema and increased intracranial pressure with elevated BP. In addition, high-quality evidence is lacking regarding optimal BP goals in patients with most of these conditions. This review summarizes guideline recommendations and examines the literature for BP management in patients with ischemic stroke, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, traumatic brain injury, and spinal cord injury.
最佳血压（BP）管理在神经危重症患者中存在争议，这是因为担心降低 BP 会加重缺血，而升高 BP 会导致脑水肿和颅内压升高。此外，对于这些情况下的最佳 BP 目标，缺乏高质量的证据。本综述总结了指南建议，并对缺血性脑卒中、脑出血、颅内动脉瘤性蛛网膜下腔出血、创伤性脑损伤和脊髓损伤患者的 BP 管理文献进行了检查。
