UMEM Educational Pearls

Title: Blood Pressure and ICH

Keywords: blood pressure, intracerebral hemorrhage (PubMed Search)

Posted: 12/31/2008 by Mike Winters, MD (Updated: 4/24/2024)
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Blood Pressure Control in ICH

Aggressive BP reduction after ICH is currently the focus of an ongoing NINDS study (ATACH Study)
Current literature recommends that extreme levels of BP after ICH be treated to reduce hematoma expansion
Mean arterial pressures (MAP) > 130 mmHg should be treated with continous IV medications
Current recommended medications include labetalol, esmolol, nicardipine, and fenoldopam
Nitroprusside is avoided by many given its tendency to increase ICP
Oral and sub-lingual medications are not indicated for immediate and precise BP control

Rincon F, Mayer SA. Clinical review: critical care management of spontaneous intracerebral hemorrhage. Crit Care 2008;12:237.