Control of hypertension in the critically ill: A pathophysiological approach

Diamantino Salgado, Eliézer Silva and Jean Louis Vincent

ULB Institutional Repository from ULB -- Universite Libre de Bruxelles

Abstract: Severe acute arterial hypertension can be associated with significant morbidity and mortality. After excluding a reversible etiology, choice of therapeutic intervention should be based on evaluation of a number of factors, such as age, comorbidities, and other ongoing therapies. A rational pathophysiological approach should then be applied that integrates the effects of the drug on blood volume, vascular tone, and other determinants of cardiac output. Vasodilators, calcium channel blockers, and beta-blocking agents can all decrease arterial pressure but by totally different modes of action, which may be appropriate or contraindicated in individual patients. There is no preferred agent for all situations, although some drugs may have a more attractive profile than others, with rapid onset action, short half-life, and fewer adverse reactions. In this review, we focus on the main mechanisms underlying severe hypertension in the critically ill and how using a pathophysiological approach can help the intensivist decide on treatment options. © 2013 Ribeiro Salgado et al. licensee Springer.

Keywords: Beta-blockers; Calcium channel blockers; Cardiac output; Diuretics; Mean arterial pressure; Vasodilators (search for similar items in EconPapers)
Date: 2013
Note: SCOPUS: re.j
References: View references in EconPapers View complete reference list from CitEc
Citations:

Published in: Annals of intensive care (2013) v.3 n° 1,p.1-13

Downloads: (external link)
https://dipot.ulb.ac.be/dspace/bitstream/2013/167956/3/doi_151586.pdf Full text for the whole work, or for a work part (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:ulb:ulbeco:2013/167956

Ordering information: This working paper can be ordered from
http://hdl.handle.ne ... lb.ac.be:2013/167956

Access Statistics for this paper

More papers in ULB Institutional Repository from ULB -- Universite Libre de Bruxelles Contact information at EDIRC.
Bibliographic data for series maintained by Benoit Pauwels ().