Labetalol: Response and Safety in Critically Ill Hemorrhagic Stroke Patients

1993 ◽  
Vol 27 (2) ◽  
pp. 180-181 ◽  
Author(s):  
Rakesh V. Patel ◽  
Heather R. Kertland ◽  
Brian E. Jahns ◽  
Barbara J. Zarowitz ◽  
Mark E. Mlynarek ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mental Status ◽  
Hemorrhagic Stroke ◽  
Surgical Intensive Care Unit ◽  
Intravenous Bolus ◽  
Peak Reduction ◽  
Stroke Patients ◽  
Surgical Intensive Care ◽  
Pilot Survey ◽  
Time To Peak

Objective To observe and characterize the blood pressure (BP)-lowering and adverse hemodynamic and/or central nervous system effects of intravenous bolus doses of labetalol in hemorrhagic stroke patients. Design Observational, prospective, pilot survey conducted over an eight-week period. Setting Surgical intensive care unit. Participants Patients admitted with an intracerebral or subarachnoid hemorrhage. Main Outcome Parameters Absolute decline in systolic BP (SBP) and diastolic BP (DBP), time to peak reduction in SBP and DBP, and adverse hemodynamic and mental status changes. Results Labetalol at doses between 5 and 25 mg lowered SBP by 6–19 percent (baseline 152–184 mm Hg) and DBP by 3–26 percent (baseline 50–99 mm Hg). Adverse hemodynamic or mental status changes were not detected following labetalol administration. Conclusions Small (≤25 mg) intravenous bolus doses of labetalol produce mild decreases in BP in hemorrhagic stroke patients.

scholarly journals An Undiagnosed Paraganglioma in a 58-Year-Old Female Who Underwent Tumor Resection

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
William C. Fox ◽  
Matthew Read ◽  
Richard E. Moon ◽  
Eugene W. Moretti ◽  
Brian J. Colin
Keyword(s):  
Blood Pressure ◽  
Perioperative Management ◽  
Clinical Presentation ◽  
Tumor Resection ◽  
Healthcare Providers ◽  
Surgical Intensive Care Unit ◽  
High Morbidity ◽  
Tumor Removal ◽  
Surgical Intensive Care ◽  
Acute Complications

Paragangliomas and pheochromocytomas are rare neuroendocrine tumors that can have high morbidity and mortality if undiagnosed. Here we report a case of an undiagnosed paraganglioma in a 58-year-old female who underwent tumor resection. The patient became severely hypertensive intraoperatively with paroxysmal swings in blood pressure and then later became acutely hypotensive after tumor removal. She was managed in the surgical intensive care unit (SICU) postoperatively and discharged from the hospital without acute complications. We briefly discuss the epidemiology, clinical presentation, perioperative management, and possible complications of these tumors to assist healthcare providers if one were to encounter them.

scholarly journals ANALYSIS OF PREDICTIVE FACTORS OF MORTALITY IN HEMORRHAGIC STROKE PATIENTS AT SOEBANDI HOSPITAL JEMBER

2017 ◽  
Vol 2 (2) ◽  
pp. 134 ◽  
Author(s):  
Rida Darotin ◽  
Nurdiana Nurdiana ◽  
Tina Handayani Nasution
Keyword(s):  
Blood Pressure ◽  
Lipid Profile ◽  
Blood Sugar ◽  
Hemorrhagic Stroke ◽  
Blood Lipid ◽  
Dominant Factor ◽  
P Value ◽  
Elevated Blood ◽  
Stroke Patients ◽  
Blood Lipid Profile

Stroke is a cerebrovascular disease that is often found in developed countries and currently also presents in developing countries, and one of them is in Indonesia. The high prevalence of stroke in Indonesia is affected by several risk factors such as obesity, lack of physical activity, unhealthy diet, smoking, high blood pressure, elevated blood sugar, and elevated blood lipid profile. The purpose of this study was to analyze the relationship between predictors of hemorrhagic stroke such as obesity, blood pressure, blood sugar and blood lipid profile with mortality in hemorrhagic stroke patients in RSD dr. Soebandi Jember. This research was a quantitative research with a retrospective approach. The number of samples was 101 medical record data. Univariate analysis was used to identify the description of each variable, a chi-square test was applied to analyze the correlation between variables, and the logistic regression analysis was applied to identify the most dominant factor influencing mortality of hemorrhagic stroke. The result of bivariate test showed p-value of obesity= 0,039, p-value of blood pressure= 0,478, p-value of blood sugar= 0,04, p-value of blood lipid profile= 0,026. Logistic regression obtained p-value for obesity= 0.043, OR = 2.689; p-value of blood sugar= 0,042, OR = 2,656; p-value of blood lipid profile= 0.069, OR = 3,749. There was a significant association between obesity, blood sugar, and blood lipid profile with mortality in hemorrhagic stroke patients. Obesity and blood sugar are predictors that can be used to predict mortality in hemorrhagic stroke patients, where obesity is the most dominant factor affecting mortality in hemorrhagic stroke patients.

Effects of patient-controlled analgesia on postoperative anxiety in elderly men

1993 ◽  
Vol 2 (2) ◽  
pp. 118-124 ◽  
Author(s):  
AM Egbert ◽  
LL Lampros ◽  
LL Parks
Keyword(s):  
Mental Status ◽  
State Anxiety ◽  
Controlled Trial ◽  
Chronically Ill ◽  
Mood States ◽  
Surgical Intensive Care Unit ◽  
Patient Controlled Analgesia ◽  
Surgical Intensive Care ◽  
Intramuscular Injections ◽  
Psychological Parameters

OBJECTIVE: To determine whether the use of patient-controlled analgesia vs intramuscular injections improves postoperative psychological parameters, particularly anxiety. DESIGN: Randomized, controlled trial of patient-controlled analgesia vs as-needed intramuscular morphine with pre- and postoperative assessments of pain, mental status, narcotic use, anxiety and mood states. SETTING: General surgical wards and surgical intensive care unit at a Veterans Administration hospital. PATIENTS: Eighty-three elderly, chronically ill males undergoing major elective surgery. INTERVENTION: Subjects randomized to receive postoperative patient-controlled analgesia vs as-needed intramuscular morphine. Pre- and postoperative assessments of State-Trait Anxiety Inventory, McGill-Dartmouth Part IV and Short Portable Mental Status Questionnaire. Pain (using linear analog scale), sedation score and narcotic use assessed every 4 hours for 72 hours. RESULTS: No differences were found in state anxiety or self-perceived mood states. Postoperative state anxiety was found to relate most closely to preoperative anxiety and postoperative complications, rather than method of analgesia or severity of pain. However, patient-controlled analgesia subjects had significantly improved analgesia and increased satisfaction. CONCLUSION: The use of patient-controlled analgesia does not significantly alter the measured psychological parameters, compared with intramuscular injections. Improved analgesia is the result of pharmacologic effects, independent of psychological factors.

Reliability of nurses' neurological assessments in the cardiothoracic surgical intensive care unit

2001 ◽  
Vol 10 (5) ◽  
pp. 298-305 ◽  
Author(s):  
K Beauchamp ◽  
S Baker ◽  
C McDaniel ◽  
W Moser ◽  
DC Zalman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cognitive Function ◽  
Mental Status ◽  
Interrater Reliability ◽  
Surgical Intensive Care Unit ◽  
Metabolic Factors ◽  
Surgical Intensive Care ◽  
Care Evaluation ◽  
Neurological State

BACKGROUND: Alterations in mental status are common among patients in the cardiothoracic surgical intensive care unit. Changes in mental status can be caused by metabolic factors, medications, or brain injury. In this setting, reliable, serial neurological evaluations are critical for assessing the effectiveness of treatment and the need for additional studies. OBJECTIVES: To estimate the reliability of the Rancho Los Amigos Cognitive Scale and the newly developed Neurologic Intensive Care Evaluation as measures of cognitive function in the cardiothoracic surgical intensive care unit. METHODS: Nurses used 1 of the 2 scales as part of routine neurological assessments of patients in the cardiothoracic surgical intensive care unit. For each test, scores of different observers were correlated and a reliability estimate formed. RESULTS: Interrater reliability was high for both evaluations (Rancho scale, 0.91; Neurologic Intensive Care Evaluation, 0.94). Correlations between the scores of different pairs of observers were also high (mean rho values, 0.84 for the Rancho scale and 0.77 for the Neurologic Intensive Care Evaluation). CONCLUSIONS: Both scales are reliable indicators of the neurological state of patients in the cardiothoracic surgical intensive care unit. These scales measure different, although limited, aspects of cognitive function. Each test was simple to administer and did not take more time than the standard nursing neurological examination. Most of the variability in scoring was related to the different degrees of stimulation used by examiners when assessing patients, not to differences in the interpretation of patients' responses.

scholarly journals Towards precision critical care management of blood pressure in hemorrhagic stroke patients using dynamic linear models

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0220283
Author(s):  
Yuzhe Liu ◽  
Jody Manners ◽  
Yazan Bittar ◽  
Sherry H-Y. Chou ◽  
Vanathi Gopalakrishnan
Keyword(s):  
Blood Pressure ◽  
Critical Care ◽  
Care Management ◽  
Hemorrhagic Stroke ◽  
Linear Models ◽  
Stroke Patients ◽  
Dynamic Linear Models ◽  
Critical Care Management

scholarly journals Hubungan Tekanan Darah dengan Volume Pendarahan Intraserebral pada Pasien Stroke Hemoragik di Ruang Rawat Inap Saraf Rumkital Dr Ramelan Surabaya

2019 ◽  
Vol 16 (2) ◽  
pp. 135
Author(s):  
KENNY YULIAN ◽  
OLIVIA MAHARDANI ADAM ◽  
LESTARI DEWI
Keyword(s):  
Blood Pressure ◽  
Ct Scan ◽  
Intracerebral Haemorrhage ◽  
Hemorrhagic Stroke ◽  
Haemorrhagic Stroke ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Stroke Patients ◽  
Cross Sectional ◽  
The Brain

<p><strong>ABSTRACT</strong></p><p><strong>Background.</strong> Hemorrhagic stroke is a spontaneous bleeding in the brain that is usually life threatening. The most common risk factor of hemorrhagic stroke is hypertension. Hypertension can cause change in the structure of the artery wall which can cause the blood vessels near the brain to rupture easily. <strong>Purpose.</strong> To analyze the correlation between blood pressure and intracerebral haemorrhage volume in hemorrhagic stroke patients in Dr. Ramelan Navy Hospital neurologic ward.  <strong>Method.</strong> This research is using a cross sectional study design. This study is done using primary data collection, using the head CT Scan result to measure the patient’s intracerebral hemorrhage volume and patient’s ER admission data for the blood pressure. <strong>Results.</strong> The study is performed to 26 haemorrhagic stroke patients who fits the inclusion and exclusion criteria. Correlation test shows no correlation between blood pressure and intracerebral haemorrhage volume in haemorrhagic stroke patients in Dr. Ramelan Navy Hospital neurologic ward, with significance (p) value of 0.888 &gt; α (0.05). <strong>Conclusion.</strong> There is no correlation between blood pressure and intracerebral haemorrhage volume in haemorrhagic stroke patients in Dr. Ramelan Navy Hospital neurologic ward.</p><p><strong>Keywords: </strong>Blood Pressure, Intracerebral Haemorrhage Volume, Haemorrhagic Stroke</p><p> </p><p>ABSTRAK</p><p><strong>Latar belakang. </strong>Stroke hemoragik adalah pendarahan otak spontan yang seringkali mengancam jiwa. Faktor resiko utama terjadinya stroke hemoragik adalah adanya hipertensi. Hipertensi dapat menyebabkan perubahan struktur dinding arteri sehingga pembuluh darah didekat otak mudah ruptur. <strong>Tujuan penelitian.</strong> Mengetahui hubungan antara tekanan darah dengan volume pendarahan intraserebral pada pasien stroke hemoragik di ruang rawat inap saraf RUMKITAL Dr. Ramelan Surabaya. <strong>Metode penelitian.</strong> Penelitian ini adalah penelitian dengan desain cross sectional study. Penelitian ini dilakukan dengan perolehan data primer, yaitu berupa hasil CT scan kepala untuk mengetahui volume pendarahan intraserebral pasien dan data pasien saat masuk IGD untuk tekanan darah pasien. <strong>Hasil.</strong> Penelitian dilakukan pada 26 pasien stroke hemoragik yang masuk kriteria inklusi dan eksklusi. Hasil uji korelasi menunjukkan tidak ada hubungan antara tekanan darah dengan volume pendarahan intraserebral pada pasien stroke hemoragik di ruang rawat inap saraf RUMKITAL Dr. Ramelan Surabaya, dengan nilai signifikansi (p) = 0.888 &gt; α (0.05). <strong>Kesimpulan.</strong> Tidak ada hubungan antara tekanan darah dengan volume pendarahan intraserebral pada pasien stroke hemoragik di ruang rawat inap saraf RUMKITAL Dr. Ramelan Surabaya.</p><strong>Kata Kunci : </strong>Tekanan Darah, Volume Pendarahan Intraserebral, Stroke Hemoragik

scholarly journals Admission blood pressure indexes and risk of in-hospital death and dependency among acute hemorrhagic stroke patients, Inner Mongolia, China

2009 ◽  
Vol 32 (5) ◽  
pp. 307 ◽  
Author(s):  
Huan Zhang ◽  
Zhong Ju ◽  
Tan Xu ◽  
Weijun Tong ◽  
Erdunchaolu Jin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Inner Mongolia ◽  
Chinese Population ◽  
Hemorrhagic Stroke ◽  
Multiple Logistic Regression Analysis ◽  
Hospital Death ◽  
Multiple Logistic Regression ◽  
Odds Ratios ◽  
Stroke Patients ◽  
Acute Hemorrhagic Stroke

Purpose: To study the association between blood pressure (BP) SBP, DBP, mean arterial pressure (MAP) and pulse pressure (PP) and clinical outcome in acute hemorrhagic stroke patients in the Chinese population. Methods: 1,760 hemorrhagic stroke patients admitted to six hospitals from January 1, 2003 to December 31, 2005 were included in the study. BP and other variables were collected within the first 24-hr of admission. Clinical outcomes at discharge were evaluated by neurologists. Multivariate-adjusted odds ratios associated with increment of 1 standard deviation (SD) mmHg in four BP were determined by multiple logistic regression analysis. Results: The four BP indexes at admission were positively associated with death and SBP, DBP, MAP were associated with dependency. Adjusted odds ratios (95% confident interval) of death associated with increment of 1 SD mmHg were 1.74 (1.44,2.12), 1.39 (1.15,1.69),1.61 (1.32,1.96) and 1.66 (1.39,1.99) for SBP, DBP, MAP and PP, respectively (all P < 0.01), and adjusted odds ratio of dependency associated with increment of 1 SD mmHg was 1.15 (1.03,1.27), 1.21 (1.09,1.34) and 1.19 (1.07,1.32) for SBP, DBP and MAP, respectively (all P < 0.05). Conclusion: Increased SBP, DBP, MAP and PP at admission were all associated with in-hospital mortality, and increased SBP, DBP and MAP were associated with dependency at discharge among hemorrhagic stroke patients.

scholarly journals Association between blood pressure and acute phase stroke case fatality rate: a prospective cohort study

2018 ◽  
Vol 76 (7) ◽  
pp. 436-443 ◽  
Author(s):  
Natalia Eduarda Furlan ◽  
Silméia Garcia Zanati Bazan ◽  
Gabriel Pereira Braga ◽  
Meire Cristina Novelli e Castro ◽  
Roberto Jorge da Silva Franco ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Intensive Care ◽  
Ischemic Stroke ◽  
Systolic Blood Pressure ◽  
Acute Phase ◽  
Hemorrhagic Stroke ◽  
Case Fatality ◽  
Stroke Patients ◽  
Intensive Care Patients

ABSTRACT Objective ed to investigate the association between blood pressure and acute phase stroke lethality in a Brazilian intensive care unit. Methods This was an observational, prospective cohort study of hemorrhagic and ischemic stroke intensive care patients. The primary outcome was all-cause mortality during the first seven days. Results There were 146 patients, aged 66 ± 13.4 years, 56% men, 89% Caucasian, 69% had ischemic stroke, and 80% were hypertensive. The median of the National Institutes of Health Stroke Scale score was 16. There were 101 ischemic stroke patients and 45 hemorrhagic stroke patients. In the ischemic stroke patients, logistic regression analysis identified low systolic blood pressure as an independent ominous prognostic factor and the optimal cut off was a mean of systolic blood pressure ≤ 131 mmHg during the first 48 hours from admission for prediction of death. No association was found for hemorrhagic stroke. Conclusions There was a negative association between systolic blood pressure and case fatality ratio of acute phase stroke in ischemic stroke intensive care patients.

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