PDF(Pubmed)
Abstract：
Background Recommendations on optimal agents to manage blood pressure (BP) in patients with an intracranial hemorrhage (ICH) are lacking. A case series suggests that hydralazine can cause intracranial pressure (ICP) elevation in an ICH. The purpose of this study was to compare the effects of intravenous (IV) hydralazine to IV labetalol on ICP in patients with ICH. Materials and methods A retrospective chart review from September 2015 to September 2021 on adults admitted to a level I trauma center with ICH, requiring an external ventricular drain or ICP monitor, and pharmacologic intervention with IV hydralazine or IV labetalol. ICP measurements and clinical interventions 0-80 minutes prior to and after medication administration were compared. Data points were excluded if multiple antihypertensive agents were administered. Results A total of 27 patients were included (three received only hydralazine, 13 only labetalol, and 11 both). Twenty-seven doses of hydralazine and 115 doses of labetalol were compared. There was no significant difference in mean ICP 0-80 minutes following hydralazine and labetalol administration (p = 0.283). Of the hydralazine doses, 29.6% received intervention for elevated ICP, while 25.2% of labetalol doses received intervention (p = 0.633). Hydralazine patients received m = 0.56 interventions for ICP, and labetalol patients received m = 0.36 interventions (p = 0.223). Of the patients that required intervention for ICP management, hydralazine patients required m = 1.88 interventions, while labetalol patients required m = 1.41 interventions (p = 0.115). Conclusion There was no significant difference in mean ICP at 0-80 minutes following administration of hydralazine or labetalol. There was also no significant difference in interventions required for elevated ICP management between groups. Larger studies are needed to confirm these findings.
摘要：
背景颅内出血（ICH）患者血压控制（BP）的最佳药物缺乏建议。一系列病例表明，肼屈嗪可导致ICH中颅内压（ICP）升高。这项研究的目的是比较静脉注射（IV）肼屈嗪与IV拉贝洛尔对ICH患者ICP的影响。材料和方法2015年9月至2021年9月，对患有ICH的I级创伤中心的成年人进行回顾性图表回顾，需要外部心室引流或ICP监测器，和静脉注射肼屈嗪或静脉注射拉贝洛尔的药物干预。比较药物施用之前和之后0-80分钟的ICP测量和临床干预。如果施用多种抗高血压药,则排除数据点。结果共纳入27例患者(3例仅接受肼屈嗪,13只拉贝洛尔，和11两者）。比较了27种剂量的肼屈嗪和115种剂量的拉贝洛尔。在给予肼屈嗪和拉贝洛尔后0-80分钟的平均ICP没有显着差异（p=0.283）。在肼屈嗪的剂量中，29.6％的人接受了ICP升高的干预，而25.2％的拉贝洛尔剂量接受了干预（p=0.633）。肼屈嗪患者接受了m=0.56的ICP干预措施，拉贝洛尔患者接受m=0.36干预（p=0.223）。在需要干预ICP管理的患者中，肼屈嗪患者需要m=1.88干预措施，而拉贝洛尔患者需要m=1.41干预(p=0.115)。结论服用肼屈嗪或拉贝洛尔后0-80分钟，平均ICP没有显着差异。两组之间升高ICP管理所需的干预措施也没有显着差异。需要更大规模的研究来证实这些发现。
