Management of perioperative hypertensive urgencies with parenteral medications

Ahuja, Kartikya; Charap, Mitchell

doi:10.1002/jhm.629

Cited by 24 publications

(12 citation statements)

References 58 publications

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“…The ethical committee approved the study (reference number 15068/15), and written informed consent was waived for all subjects. We excluded patients with sepsis, preexisting high levels of hsTnT, end-stage renal disease (ESRD), and AKI before the surgery, as well as patients with marked intraoperative hypotension (mean arterial blood pressure less than 33% of the initial value for more than 10 min) [ 20 ]. A total of 19 patients were excluded.…”

Section: Methodsmentioning

confidence: 99%

Acute kidney injury induces high-sensitivity troponin measurement changes after cardiac surgery

et al. 2017

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BackgroundThe value of cardiac troponin as a risk assessment tool for cardiac disease in the setting of end-stage renal diseases (ESRD) is not equivalent to its value in those with normal renal function. This consideration had not been studied in settings of acute kidney injury (AKI). We aim to explore the diagnostic value of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI.MethodsSingle center observational retrospective study. Based on the AKI Network, patients divided into 2 groups, group I without AKI (259 patients) and group II with AKI (100 patients) where serial testing of hsTnT and creatine kinase (CK)-MB were followed in both groups. Patients with (ESRD) were excluded.ResultsThe mean age in our study was 55.1 ± 10.2 years. High association of AKI (27.8%) was found in our patients. Both groups were matched regarding the age, gender, body mass index, the association of diabetes or hypertension, and Euro score. AKI group had significantly higher mortality 5% vs group I 1.1% (p = 0.03). The hsTnt showed a significant sustained rise in the AKI group as compared to the non-AKI group, however CK-MB changes were significant initially but not sustained.The AKI group was more associated with heart failure 17.9% vs 4.9% (p = 0.001); and post-operative atrial fibrillation, 12.4% vs 2.9% (p = 0.005). Lengths of ventilation, stays in ICU and in hospital were significantly higher in the AKI group.ConclusionsUnlike the CK-MB profile, the hsTnT showed significant changes between both groups all over the course denoting possible delayed clearance in patients with AKI.

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Section: Methodsmentioning

confidence: 99%

Acute kidney injury induces high-sensitivity troponin measurement changes after cardiac surgery

et al. 2017

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“…This was explained by him using an example such as, in the perioperative setting, stimuli such as elevated BP during anesthesia induction, tracheal intubation, and emergence from anesthesia can be the initiating event for the hypertensive crisis 13 . Anesthesia induction alone can cause an increase of 20 mmHg in normotensive patients, and up to 90 mmHg in patients with a preexisting hypertensive condition 14 .…”

Section: Pathophysiology Of Hypertensionmentioning

confidence: 99%

Untitled

2014

IJPSR

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Micronutrient deficiencies such as potassium, magnesium and calcium are very common in the general population and it is more predominantly present in the individuals with hypertension and cardiovascular patients. These deficiencies will have a massive impact on present and future cardiovascular health outcomes such as hypertension, myocardial infarction, stroke, etc. Recent efforts to reduce the prevalence of hypertension have focused on non-pharmacologic means, specifically diet in order to overcome micronutrient deficiencies. From most of the studies it is evident that an increased intake of minerals such as potassium, magnesium, and calcium by dietary means to reduce blood pressure in patients with hypertension. This article also focuses on how these minerals influence vaso dilation, rennin-angiotension and aldosterone system, natriuresis, sympathetic nervous system nitric oxide production and vascular injury. On the whole, this review will talk about the roles of potassium, magnesium, and calcium in the prevention and treatment of hypertension with specific emphasis on clinical trial evidence, mechanism of action, and recommendations for dietary intake of these minerals.

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“…En cambio, durante la fase postoperatoria, la descarga simpática vuelve a aumentar, generalmente por factores como el dolor, la ansiedad, la hipotermia, la hipoxemia, la hipercarbia y la sobrecarga hídrica. Esto conlleva a un incremento de la resistencia vascular periférica (RVP) y por lo tanto de la PA y FC 20,22 . Desafortunadamente, la variabilidad intraoperatoria de la PA no es inocua.…”

Section: Introductionunclassified