• Login
    View Item 
    •   Home
    • University Hospitals of Derby and Burton NHS Foundation Trust
    • Division of Medicine
    • Specialist Medicine
    • View Item
    •   Home
    • University Hospitals of Derby and Burton NHS Foundation Trust
    • Division of Medicine
    • Specialist Medicine
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of EMERCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjectsProfilesView

    My Account

    LoginRegister

    Links

    About EMERPoliciesDerbyshire Community Health Services NHS Foundation TrustLeicester Partnership TrustNHS Nottingham and Nottinghamshire CCGNottinghamshire Healthcare NHS Foundation TrustNottingham University Hospitals NHS TrustSherwood Forest Hospitals NHS Foundation TrustUniversity Hospitals of Derby and Burton NHS Foundation TrustUniversity Hospitals Of Leicester NHS TrustOther Resources

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Pressor therapy in acute ischaemic stroke: an updated systematic review.

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    (813) Euro Stroke.pdf
    Size:
    968.8Kb
    Format:
    PDF
    Download
    Author
    England, Tim
    Keyword
    Acute
    Blood Pressure
    Elevation
    Induced Hypertension
    Ischaemic Stroke
    Vasopressor
    
    Metadata
    Show full item record
    Abstract
    BACKGROUND: Low blood pressure (BP) in acute ischaemic stroke (AIS) is associated with poor functional outcome, death, or severe disability. Increasing BP might benefit patients with post-stroke hypotension including those with potentially salvageable ischaemic penumbra. This updated systematic review considers the present evidence regarding the use of vasopressors in AIS. METHODS: We searched the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE and trial databases using a structured search strategy. We examined reference lists of relevant publications for additional studies examining BP elevation in AIS. RESULTS: We included 27 studies involving 1886 patients. Nine studies assessed increasing BP during acute reperfusion therapy (intravenous thrombolysis, mechanical thrombectomy, intra-arterial thrombolysis or combined). Eighteen studies tested BP elevation alone. Phenylephrine was the most commonly used agent to increase BP (n = 16 studies), followed by norepinephrine (n = 6), epinephrine (n = 3) and dopamine (n = 2). Because of small patient numbers and study heterogeneity, a meta-analysis was not possible. Overall, BP elevation was feasible in patients with fluctuating or worsening neurological symptoms, large vessel occlusion with labile BP, sustained post-stroke hypotension and ineligible for intravenous thrombolysis or after acute reperfusion therapy. The effects on functional outcomes were largely unknown and close monitoring is advised if such intervention is undertaken. CONCLUSION: Although theoretical arguments support increasing BP to improve cerebral blood flow and sustain the ischaemic penumbra in selected AIS patients, the data are limited and results largely inconclusive. Large, randomised controlled trials are needed to identify the optimal BP target, agent, duration of treatment and effects on clinical outcomes.
    Citation
    Eur Stroke J. 2022 Jun;7(2):99-116. doi: 10.1177/23969873221078136. Epub 2022 Mar 2.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15596
    Collections
    Specialist Medicine

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.