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

Wei, Ming-Cheng; Kornelius, Edy; Chou, Ying-Hsiang; Yang, Yi-Sun; Huang, Jing-Yang; Huang, Chien-Ning

doi:10.3390/ijerph17103436

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

^1,2,

³,

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⁶

and

Chien-Ning Huang

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Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan

Department of Neurosurgery, Lee General Hospital, Yuanli Town, Miaoli 35845, Taiwan

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

⁴

Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

⁵

Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

⁶

Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2020, 17(10), 3436; https://doi.org/10.3390/ijerph17103436

Received: 13 April 2020 / Revised: 8 May 2020 / Accepted: 10 May 2020 / Published: 14 May 2020

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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. View Full-Text

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

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Wei, M.-C.; Kornelius, E.; Chou, Y.-H.; Yang, Y.-S.; Huang, J.-Y.; Huang, C.-N. Optimal Initial Blood Pressure in Intensive Care Unit Patients with Non-Traumatic Intracranial Hemorrhage. Int. J. Environ. Res. Public Health 2020, 17, 3436. https://doi.org/10.3390/ijerph17103436

AMA Style

Wei M-C, Kornelius E, Chou Y-H, Yang Y-S, Huang J-Y, Huang C-N. Optimal Initial Blood Pressure in Intensive Care Unit Patients with Non-Traumatic Intracranial Hemorrhage. International Journal of Environmental Research and Public Health. 2020; 17(10):3436. https://doi.org/10.3390/ijerph17103436

Chicago/Turabian Style

Wei, Ming-Cheng, Edy Kornelius, Ying-Hsiang Chou, Yi-Sun Yang, Jing-Yang Huang, and Chien-Ning Huang. 2020. "Optimal Initial Blood Pressure in Intensive Care Unit Patients with Non-Traumatic Intracranial Hemorrhage" International Journal of Environmental Research and Public Health 17, no. 10: 3436. https://doi.org/10.3390/ijerph17103436

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