Optimal Initial Blood Pressure in Intensive Care Unit Patients with Non-Traumatic Intracranial Hemorrhage

Int J Environ Res Public Health. 2020 May 14;17(10):3436. doi: 10.3390/ijerph17103436.

Abstract

Blood pressure (BP) control is crucial for minimizing the risk of mortality and hematoma growth in patients with acute intracranial hemorrhage (ICH). We aimed to determine the optimal BP range associated with improved patient outcomes. From the Medical Information Mart for Intensive Care-III database, we identified 1493 patients (age, 18-99 years) admitted to the intensive care unit (ICU) with non-traumatic ICH. The 3-day and 14-day mortality of ICU admissions were compared at different BP ranges. Generalized additive models were used to assess the optimal range of initial mean arterial pressure, systolic blood pressure (SBP), and diastolic blood pressure, and these were identified to be 70-100, 120-150, and 60-100 mmHg, respectively. The 3-day or 14-day mortality showed U-shaped correlations with BP ranges. Our results show that an initial SBP between 120 and 150 mmHg is associated with minimal risk of mortality risk. This recommendation can assist physicians to achieve better outcomes for patients with ICH.

Keywords: blood pressure; critical care; intracranial hemorrhage; mortality; stroke.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents
  • Blood Pressure*
  • Cerebral Hemorrhage
  • Critical Care
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Medicare
  • Middle Aged
  • United States
  • Young Adult

Substances

  • Antihypertensive Agents