Hypertension in the critically ill patient

摘要: Objective: To review the management of persistent hypertension and hypertensive crisis in critically ill patient. Data sources: A articles reported on Summary review: Hypertension is defined as a basal systolic blood pressure greater than 140 mmHg or diastolic 90 (MAP>105 mmHg), irrespective age based average two more readings occasions over period four weeks. While mean arterial up to value 135 may be tolerated for some hours, patients with dissecting aortic aneurysm, cardiac failure, angina, acute myocardial infarction, pre-eclampsia following cardiac, vascular cerebral surgery >90 should lowered by 30% urgently. MAP>160 can caused phaeochromocytoma, sympathomimetic overdose, malignant autonomic hyperreactivity secondary tetanus. Treatment requires direct intra-arterial monitoring an initial reduction no 30%. primary condition (eg surgical removal delivery termination pregnancy) also necessary, infusions sodium nitroprusside, phentolamine, hydralazine esmolol usually require supplementation oral agents angiotensin-converting enzyme inhibitors, beta adrenergic receptor antagonists calcium channel blockers) long term management. Conclusions: often hours. However disorders eclampsia surgery) treated (author abstract)