Hipertansiyon
Özet
Yoğun bakım hastalarında hipertansiyon, ciddi komplikasyonlara yol açabilen bir durumdur. Tedaviye başlamadan önce altta yatan nedenlerin belirlenmesi önemlidir. Hipertansif aciller, organ hasarıyla karakterize ve acil müdahale gerektiren durumları ifade eder. Tedavide, kan basıncının dengeli bir şekilde düşürülmesi esastır; ani düşüşler ciddi komplikasyonlara neden olabilir. Farmakolojik tedavide, alfa-1 ve beta-1 adrenerjik blokerler, kalsiyum kanal blokörleri, vazodilatatör ilaçlar ve diğer santral etkili antihipertansifler kullanılır. Tedavideki seçim hastanın durumuna ve altta yatan nedenlere bağlı olmalıdır. (Yoğun bakım, hipertansiyon, antihipertansif ilaçlar, hipertansif aciller)
Hypertension in intensive care patients is a condition that can lead to serious complications. It is important to identify the underlying causes before starting treatment. Hypertensive emergencies refer to situations characterized by organ damage and requiring urgent intervention. In treatment, it is essential to lower blood pressure in a balanced manner; sudden drops can cause serious complications. Pharmacological therapy may involve the use of alpha-1 and beta-1 adrenergic blockers, calcium channel blockers, vasodilators, and other centrally acting antihypertensive agents. The choice of treatment should depend on the patient's condition and underlying causes. (Intensive Care, hypertension, anti hypertensive, hypertensive emergencies)
Referanslar
Danaei G, Ding EL, Mozaffarian D. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Medicine. 2009;3:e1000058. doi: 10.1371/journal.pmed.1000058.
Owens WB. Blood pressure control in acute cerebrovascular disease. The Journal of Clinical Hypertension. (Greenwich) 2011;3:205–211. doi: 10.1111/j.1751-7176.2010.00394.x.
Chobanian AV, Bakris GL, Black HR. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. Journal of the American Medical Association, (2003) 289, 2560–72.
Katz JN, Gore JM, Amin A. Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry. American Heart Journal. 2009;3:599–606. doi: 10.1016/j.ahj.2009.07.020.
Davignon J and Ganz P. (2004). Role of endothelial dysfunction in atherosclerosis. Circulation, 109(23 Suppl. 1), III27–32.
Celermajer DS. (2008). Reliable endothelial function testing: at our fingertips? Circulation, 117, 2428–30.
Lerman A and Zeiher AM. (2005). Endothelial function: cardiac events. Circulation, 111, 363–8.
Davis JT, Rao F, Naqshbandi D, et al. (2012). Autonomic and hemody- namic origins of pre-hypertension: central role of heredity. Journal of the American College of Cardiology, 59, 2206–16.
Slama M, Modeliar SS. Hypertension in the intensive care unit. Current Opinion Cardiology. 2006;3:279–287. doi: 10.1097/01.hco.0000231396.56738.d8.
James PA, Oparil S, Carter BL, et al. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Journal of the American Medical Association, 311, 507–20.
Marik PE, Varon J. Perioperative hypertension: a review of current and emerging therapeutic agents. Journal of Clinical Anesthesia. 2009;3:220–229. doi: 10.1016/j.jclinane.2008.09.003.
Varon J, Marik PE. Clinical review: the management of hypertensive crises. Critical Care. 2003;3:374–384. doi: 10.1186/cc2351
Marik PE, Varon J. Hypertensive crises: challenges and management. Chest. 2007;3:1949–1962. doi: 10.1378/chest.06-2490.
Deanfield JE, Halcox JP, and Rabelink TJ. (2007). Endothelial func- tion and dysfunction: testing and clinical relevance. Circulation, 115, 1285–95.
Narotam PK, Puri V, Roberts JM. Management of hypertensive emergencies in acute brain disease: evaluation of the treatment effects of intravenous nicardipine on cerebral oxygenation. Journal of Neurosurgery. 2008;3:1065–1074. doi: 10.3171/JNS.2008.109.12.1065.
Deeks ED, Keating GM, Keam SJ. Clevidipine: a review of its use in the management of acute hypertension. American Journal of Cardiovascular Drugs. 2009;3:117–134. doi: 10.1007/BF03256583.
Awad AS, Goldberg ME. Role of clevidipine butyrate in the treatment of acute hypertension in the critical care setting: a review. Vascular Health and Risk Management 2010;3:457–464.
Pollack CV, Varon J, Garrison NA. Clevidipine, an intravenous dihydropyridine calcium channel blocker, is safe and effective for the treatment of patients with acute severe hypertension. Annals of Emergency Medicine. 2009;3:329–338. doi: 10.1016/j.annemergmed.2008.04.025.
Nguyen HM, Ma K, Pham DQ. Clevidipine for the treatment of severe hypertension in adults. Clinical Therapeutics. 2010;3:11–23. doi: 10.1016/j.clinthera.2010.01.025.
Shusterman NH, Elliott WJ, White WB. Fenoldopam, but not nitroprusside, improves renal function in severely hypertensive patients with impaired renal function. The American Journal of Medicine. 1993;3:161–168. doi: 10.1016/0002-9343(93)90256-O.
Murphy MB, Murray C, Shorten GD. Fenoldopam: a selective peripheral dopamine-receptor agonist for the treatment of severe hypertension. New England Journal of Medicine. 2001;3:1548–1557. doi: 10.1056/NEJMra010253.
Pedersen ME, Cockcroft JR. The latest generation of beta-blockers: new pharmacologic properties. Current Hypertension Reports. 2006;3:279–286. doi: 10.1007/s11906-006-0065-0.
Wiysonge CS, Bradley HA, Volmink J. Beta-blockers for hypertension. Cochrane Database of Systematic Reviews. 2012;3 CD002003.
Papadopoulos DP, Mourouzis I, Thomopoulos C. Hypertension crisis. Blood Pressure. 2010;3:328–336. doi: 10.3109/08037051.2010.488052.
Jamadarkhana S, Gopal S. Clonidine in adults as a sedative agent in the intensive care unit. Journal of Anaesthesiology Clinical Pharmacology. 2010;3:439–445.
Magee LA, Abalos E, von Dadelszen P. How to manage hypertension in pregnancy effectively. British Journal of Clinical Pharmacology. 2011;3:394–401. doi: 10.1111/j.1365-2125.2011.04002.x.
McMillian WD, Trombley BJ, Charash WE. Phentolamine continuous infusion in a patient with pheochromocytoma. American Journal of Health System Pharmacy. 2011;3:130–134. doi: 10.2146/ajhp090619.
Gregoretti C, Moglia B, Pelosi P. Clonidine in perioperative medicine and intensive care unit: more than an anti-hypertensive drug. Current Drug Targets. 2009;3:799–814. doi: 10.2174/138945009788982478.
Prichard BN, Graham BR. I1 imidazoline agonists. General clinical pharmacology of imidazoline receptors: implications for the treatment of the elderly. Drugs Aging. 2000;3:133–159. doi: 10.2165/00002512-200017020-00005.
Farag E, Chahlavi A, Argalious M. Using dexmedetomidine to manage patients with cocaine and opioid withdrawal, who are undergoing cerebral angioplasty for cerebral vasospasm. Anesthesia and Analgesia. 2006;3:1618–1620.
Rhoney D, Peacock WF. Intravenous therapy for hypertensive emergencies, part 2. American Journal of Health System Pharmacy. 2009;3:1448–1457. doi: 10.2146/ajhp080348.p2.
Khan IA, Nair CK. Clinical, diagnostic, and management perspectives of aortic dissection. Chest. 2002;3:311–328. doi: 10.1378/chest.122.1.311.
Isso JL, Sica SA, and Black HR (eds) (2008). Hypertension Primer, American Heart Series, 4 edn. Philadelphia, PA: Lippincott Williams & Williams.
Referanslar
Danaei G, Ding EL, Mozaffarian D. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Medicine. 2009;3:e1000058. doi: 10.1371/journal.pmed.1000058.
Owens WB. Blood pressure control in acute cerebrovascular disease. The Journal of Clinical Hypertension. (Greenwich) 2011;3:205–211. doi: 10.1111/j.1751-7176.2010.00394.x.
Chobanian AV, Bakris GL, Black HR. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. Journal of the American Medical Association, (2003) 289, 2560–72.
Katz JN, Gore JM, Amin A. Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry. American Heart Journal. 2009;3:599–606. doi: 10.1016/j.ahj.2009.07.020.
Davignon J and Ganz P. (2004). Role of endothelial dysfunction in atherosclerosis. Circulation, 109(23 Suppl. 1), III27–32.
Celermajer DS. (2008). Reliable endothelial function testing: at our fingertips? Circulation, 117, 2428–30.
Lerman A and Zeiher AM. (2005). Endothelial function: cardiac events. Circulation, 111, 363–8.
Davis JT, Rao F, Naqshbandi D, et al. (2012). Autonomic and hemody- namic origins of pre-hypertension: central role of heredity. Journal of the American College of Cardiology, 59, 2206–16.
Slama M, Modeliar SS. Hypertension in the intensive care unit. Current Opinion Cardiology. 2006;3:279–287. doi: 10.1097/01.hco.0000231396.56738.d8.
James PA, Oparil S, Carter BL, et al. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Journal of the American Medical Association, 311, 507–20.
Marik PE, Varon J. Perioperative hypertension: a review of current and emerging therapeutic agents. Journal of Clinical Anesthesia. 2009;3:220–229. doi: 10.1016/j.jclinane.2008.09.003.
Varon J, Marik PE. Clinical review: the management of hypertensive crises. Critical Care. 2003;3:374–384. doi: 10.1186/cc2351
Marik PE, Varon J. Hypertensive crises: challenges and management. Chest. 2007;3:1949–1962. doi: 10.1378/chest.06-2490.
Deanfield JE, Halcox JP, and Rabelink TJ. (2007). Endothelial func- tion and dysfunction: testing and clinical relevance. Circulation, 115, 1285–95.
Narotam PK, Puri V, Roberts JM. Management of hypertensive emergencies in acute brain disease: evaluation of the treatment effects of intravenous nicardipine on cerebral oxygenation. Journal of Neurosurgery. 2008;3:1065–1074. doi: 10.3171/JNS.2008.109.12.1065.
Deeks ED, Keating GM, Keam SJ. Clevidipine: a review of its use in the management of acute hypertension. American Journal of Cardiovascular Drugs. 2009;3:117–134. doi: 10.1007/BF03256583.
Awad AS, Goldberg ME. Role of clevidipine butyrate in the treatment of acute hypertension in the critical care setting: a review. Vascular Health and Risk Management 2010;3:457–464.
Pollack CV, Varon J, Garrison NA. Clevidipine, an intravenous dihydropyridine calcium channel blocker, is safe and effective for the treatment of patients with acute severe hypertension. Annals of Emergency Medicine. 2009;3:329–338. doi: 10.1016/j.annemergmed.2008.04.025.
Nguyen HM, Ma K, Pham DQ. Clevidipine for the treatment of severe hypertension in adults. Clinical Therapeutics. 2010;3:11–23. doi: 10.1016/j.clinthera.2010.01.025.
Shusterman NH, Elliott WJ, White WB. Fenoldopam, but not nitroprusside, improves renal function in severely hypertensive patients with impaired renal function. The American Journal of Medicine. 1993;3:161–168. doi: 10.1016/0002-9343(93)90256-O.
Murphy MB, Murray C, Shorten GD. Fenoldopam: a selective peripheral dopamine-receptor agonist for the treatment of severe hypertension. New England Journal of Medicine. 2001;3:1548–1557. doi: 10.1056/NEJMra010253.
Pedersen ME, Cockcroft JR. The latest generation of beta-blockers: new pharmacologic properties. Current Hypertension Reports. 2006;3:279–286. doi: 10.1007/s11906-006-0065-0.
Wiysonge CS, Bradley HA, Volmink J. Beta-blockers for hypertension. Cochrane Database of Systematic Reviews. 2012;3 CD002003.
Papadopoulos DP, Mourouzis I, Thomopoulos C. Hypertension crisis. Blood Pressure. 2010;3:328–336. doi: 10.3109/08037051.2010.488052.
Jamadarkhana S, Gopal S. Clonidine in adults as a sedative agent in the intensive care unit. Journal of Anaesthesiology Clinical Pharmacology. 2010;3:439–445.
Magee LA, Abalos E, von Dadelszen P. How to manage hypertension in pregnancy effectively. British Journal of Clinical Pharmacology. 2011;3:394–401. doi: 10.1111/j.1365-2125.2011.04002.x.
McMillian WD, Trombley BJ, Charash WE. Phentolamine continuous infusion in a patient with pheochromocytoma. American Journal of Health System Pharmacy. 2011;3:130–134. doi: 10.2146/ajhp090619.
Gregoretti C, Moglia B, Pelosi P. Clonidine in perioperative medicine and intensive care unit: more than an anti-hypertensive drug. Current Drug Targets. 2009;3:799–814. doi: 10.2174/138945009788982478.
Prichard BN, Graham BR. I1 imidazoline agonists. General clinical pharmacology of imidazoline receptors: implications for the treatment of the elderly. Drugs Aging. 2000;3:133–159. doi: 10.2165/00002512-200017020-00005.
Farag E, Chahlavi A, Argalious M. Using dexmedetomidine to manage patients with cocaine and opioid withdrawal, who are undergoing cerebral angioplasty for cerebral vasospasm. Anesthesia and Analgesia. 2006;3:1618–1620.
Rhoney D, Peacock WF. Intravenous therapy for hypertensive emergencies, part 2. American Journal of Health System Pharmacy. 2009;3:1448–1457. doi: 10.2146/ajhp080348.p2.
Khan IA, Nair CK. Clinical, diagnostic, and management perspectives of aortic dissection. Chest. 2002;3:311–328. doi: 10.1378/chest.122.1.311.
Isso JL, Sica SA, and Black HR (eds) (2008). Hypertension Primer, American Heart Series, 4 edn. Philadelphia, PA: Lippincott Williams & Williams.
