Why we still don't achieve blood pressure targets

Renal transplant surgery may be associated with important perioperative complications. In this scenario, the anesthetic technique should provide optimal conditions for the surgical team, guarantee hemodynamic stability and kidney perfusion, and adequate analgesia. Preoperative evaluation should always be performed. In the intraoperative period, standard monitoring is sufficient in most cases. General balanced anesthesia, alone or in combination with spinal anesthesia or peripheral block, is the technique of choice. Management of blood pressure during the surgery is crucial. Before reperfusion, a mean arterial blood pressure of 65 mmHg is recommended, increasing to 80–90 mmHg when reperfusion is imminent until the end of surgery. Vasopressors, such as ephedrine, may be necessary to achieve blood pressure targets. Mannitol and furosemide are commonly used to increase urine output. In the postoperative period, analgesia should be ensured.

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The use of highly structured care to achieve blood pressure targets

BMJ ◽

10.1136/bmj.e7777 ◽

2012 ◽

Vol 345 (nov20 1) ◽

pp. e7777-e7777 ◽

Cited By ~ 2

Author(s):

C. E. Clark ◽

R. McManus

Keyword(s):

Blood Pressure ◽

Blood Pressure Targets ◽

Structured Care ◽

Achieve Blood Pressure

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165 DOES FRUIT AND VEGETABLE CONSUMPTION INFLUENCE THE QUANTUM OF BLOOD PRESSURE LOWERING THERAPY REQUIRED TO ACHIEVE BLOOD PRESSURE TARGETS IN PATIENTS WITH CORONARY HEART DISEASE?

Journal of Hypertension ◽

10.1097/01.hjh.0000419990.91644.90 ◽

2012 ◽

Vol 30 ◽

pp. e50

Author(s):

Vernon Heazlewood ◽

Kornelia Kotseva ◽

Elizabeth Turner ◽

David Wood

Keyword(s):

Blood Pressure ◽

Coronary Heart Disease ◽

Heart Disease ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Blood Pressure Lowering ◽

Blood Pressure Targets ◽

Lowering Therapy ◽

Achieve Blood Pressure ◽

Pressure Lowering

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Blood pressure lowering in the oldest old: a step toward abandoning arbitrary blood pressure targets

Journal of Hypertension ◽

10.1097/hjh.0b013e328341af1e ◽

2011 ◽

Vol 29 (1) ◽

pp. 173-175 ◽

Cited By ~ 1

Author(s):

Gianpaolo Reboldi ◽

Giorgio Gentile ◽

Fabio Angeli ◽

Paolo Verdecchia

Keyword(s):

Blood Pressure ◽

Oldest Old ◽

Blood Pressure Lowering ◽

Blood Pressure Targets ◽

Pressure Lowering

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Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section

Intensive Care Medicine Experimental ◽

10.1186/s40635-019-0280-z ◽

2019 ◽

Vol 7 (1) ◽

Cited By ~ 1

Author(s):

M. Ostermann ◽

A. Schneider ◽

T. Rimmele ◽

I. Bobek ◽

M. van Dam ◽

...

Keyword(s):

Blood Pressure ◽

Critical Care ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Critically Ill ◽

Critically Ill Patients ◽

Future Research ◽

Knowledge Gaps ◽

Blood Pressure Targets

Abstract Purpose Critical Care Nephrology is an emerging sub-specialty of Critical Care. Despite increasing awareness about the serious impact of acute kidney injury (AKI) and renal replacement therapy (RRT), important knowledge gaps persist. This report represents a summary of a 1-day meeting of the AKI section of the European Society of Intensive Care Medicine (ESICM) identifying priorities for future AKI research. Methods International Members of the AKI section of the ESICM were selected and allocated to one of three subgroups: “AKI diagnosis and evaluation”, “Medical management of AKI” and “Renal Replacement Therapy for AKI.” Using a modified Delphi methodology, each group identified knowledge gaps and developed potential proposals for future collaborative research. Results The following key research projects were developed: Systematic reviews: (a) epidemiology of AKI with stratification by patient cohorts and diagnostic criteria; (b) role of higher blood pressure targets in patients with hypertension admitted to the Intensive Care Unit, and (c) specific clearance characteristics of different modalities of continuous renal replacement therapy (CRRT). Observational studies: (a) epidemiology of critically ill patients according to AKI duration, and (b) current clinical practice of CRRT. Intervention studies:( a) Comparison of different blood pressure targets in critically ill patients with hypertension, and (b) comparison of clearance of solutes with various molecular weights between different CRRT modalities. Conclusion Consensus was reached on a future research agenda for the AKI section of the ESICM.

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