Document Detail


Nicardipine infusion for blood pressure control in patients with subarachnoid hemorrhage.
MedLine Citation:
PMID:  20535586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: To evaluate the efficacy, tolerability, and safety of nicardipine infusion in controlling the elevated blood pressure after subarachnoid hemorrhage (SAH).
METHODS: Nicardipine infusion was initiated if the individual pre-specified systolic blood pressure (SBP) level goal, mandated by the admitting neurosurgeon, was not met. Systolic and diastolic BPs were measured on admission, hourly during the infusion and 12 h before and after the infusion.
RESULTS: Twenty-eight patients with SAH required 50 nicardipine infusions in order to achieve a mean SBP goal of 152 mmHg. The 3,112 extracted BP measurements showed that mean infusion SBP was significantly lower than admission and pre-infusion SBP (mean 146.5 vs. 177.1 and 155.6 mmHg, P < 0.001, respectively) and significantly higher than post-infusion SBP (146.5 vs. 142.6 mmHg, P = 0.002). Five infusions were stopped prematurely, because of hypotension (n = 3), emergent surgery (n = 1), and failure to reach the SBP goal (n = 1). Rebleeding was not observed in any patient. Nicardipine achieved SBP control in 59.9% of hourly infusion measurements, with a trend for higher proportion of success with higher SBP goals.
CONCLUSION: In this study, nicardipine infusion was a safe and moderately effective treatment for BP control in patients with SAH. Although SBP during nicardipine infusion was higher than the pre-specified goal in a significant percentage of hourly observations, this may be due to the drug administration protocol and other factors such as analgesia and sedation.
Authors:
Panayiotis N Varelas; Tamer Abdelhak; Jody Wellwood; Irem Shah; Lotfi Hacein-Bey; Lonni Schultz; Panayiotis Mitsias
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurocritical care     Volume:  13     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-22     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  190-8     Citation Subset:  IM    
Affiliation:
Department of Neurology, K-11, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202, USA. varelas@neuro.hfh.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / administration & dosage,  therapeutic use
Blood Pressure / drug effects*
Diastole / drug effects
Female
Glasgow Coma Scale
Homeostasis
Humans
Infusions, Intravenous
Intracranial Aneurysm / drug therapy
Male
Middle Aged
Nicardipine / administration & dosage,  therapeutic use
Subarachnoid Hemorrhage / drug therapy*
Systole / drug effects
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 55985-32-5/Nicardipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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