Tucker Natalie, Stoffel Jaclyn M, Hayes Lisa, Jones G Morgan
Methodist University Hospital, Memphis, Tennessee (Drs Tucker, Stoffel, Hayes, and Jones); and College of Pharmacy (Drs Stoffel, Hayes, and Jones) and Medicine (Jones), University of Tennessee Health Sciences Center, Memphis.
Crit Care Nurs Q. 2020 Apr/Jun;43(2):109-121. doi: 10.1097/CNQ.0000000000000297.
Elevated blood pressure is common in patients with acute ischemic stroke. While this may occur secondary to the body's own response to preserve cerebral blood flow, elevated blood pressure may also increase the risk of hemorrhagic transformation. Current guidelines recommend various blood pressure goals based upon multiple factors, including thresholds specific to certain treatment interventions. Despite these guidelines, there is limited evidence to support specific blood pressure targets, and variability in clinical practice is common. The purpose of this review was to discuss blood pressure management in adult patients with acute ischemic stroke, focusing on appropriate targets in the setting of alteplase administration, mechanical thrombectomy, and hemorrhagic transformation.
急性缺血性卒中患者中血压升高很常见。虽然这可能继发于机体自身为维持脑血流的反应,但血压升高也可能增加出血性转化的风险。当前指南根据多种因素推荐了不同的血压目标,包括特定治疗干预措施的阈值。尽管有这些指南,但支持特定血压目标的证据有限,临床实践中的差异很常见。本综述的目的是讨论成年急性缺血性卒中患者的血压管理,重点关注在使用阿替普酶、机械取栓和出血性转化情况下的合适目标。