Blood pressure and the risk of rebleeding and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
J Crit Care
; 72: 154124, 2022 12.
Article
em En
| MEDLINE
| ID: mdl-36208555
ABSTRACT
INTRODUCTION AND OBJECTIVE:
Blood pressure is presumably related to rebleeding and delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (aSAH) and could serve as a target to improve outcome. We assessed the associations between blood pressure and rebleeding or DCI in aSAH-patients. MATERIALS ANDMETHODS:
In this observational study in 1167 aSAH-patients admitted to the intensive care unit (ICU), adjusted hazard ratio's (aHR) were calculated for the time-dependent association of blood pressure and rebleeding or DCI. The aHRs were presented graphically, relative to a reference mean arterial pressure (MAP) of 100â¯mmHg and systolic blood pressure (sBP) of 150â¯mmHg.RESULTS:
A MAP below 100â¯mmHg in the 6, 3 and 1â¯h before each moment in time was associated with a decreased risk of rebleeding (e.g. within 6â¯h preceding rebleeding MAPâ¯=â¯80â¯mmHg aHR 0.30 (95% confidence interval (CI) 0.11-0.80)). A MAP below 60â¯mmHg in the 24â¯h before each moment in time was associated with an increased risk of DCI (e.g. MAPâ¯=â¯50â¯mmHg aHR 2.59 (95% CI 1.12-5.96)).CONCLUSIONS:
Our results suggest that a MAP below 100â¯mmHg is associated with decreased risk of rebleeding, and a MAP below 60â¯mmHg with increased risk of DCI.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Hemorragia Subaracnóidea
/
Isquemia Encefálica
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Crit Care
Assunto da revista:
TERAPIA INTENSIVA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Holanda