[Vlad34]

Сообщение от servalol

По поводу коррекции АД - это действительно дискутабельная тема, но только в вопросе величины цифр АД. 220/120 это из европейских рекомендаций. Есть мнения, что поддерживать АД на уровне на 10-15% выше обычных цифр, в любом случае агрессивная гипотензивная терапия вредна.

Так и инсульты разные бывают. Вот свежее по геморрагическим: [Ссылки доступны только зарегистрированным пользователям ]

Recommendations

1. Until ongoing clinical trials of BP intervention for ICH are completed, physicians must manage BP on the basis of the present incomplete efficacy evidence. Current suggested recommendations for target BP in various situations are listed in Table 6 and may be considered (Class IIb; Level of Evidence: C). (Unchanged from the previous guideline)
2. In patients presenting with a systolic BP of 150 to 220 mm Hg, acute lowering of systolic BP to 140 mm Hg is probably safe (Class IIa; Level of Evidence: B). (New recommendation)

Table 6. Suggested Recommended Guidelines for Treating Elevated BP in Spontaneous ICH
1. If SBP is >200 mm Hg or MAP is >150 mm Hg, then consider aggressive reduction of BP with continuous intravenous infusion, with frequent BP monitoring every 5 min.
2. If SBP is >180 mm Hg or MAP is >130 mm Hg and there is the possibility of elevated ICP, then consider monitoring ICP and reducing BP using intermittent or continuous intravenous medications while maintaining a cerebral perfusion pressure ≥60 mm Hg.
3. If SBP is >180 mm Hg or MAP is >130 mm Hg and there is not evidence of elevated ICP, then consider a modest reduction of BP (eg, MAP of 110 mm Hg or target BP of 160/90 mm Hg) using intermittent or continuous intravenous medications to control BP and clinically reexamine the patient every 15 min.
Note that these recommendations are Class C. SBP indicates systolic blood pressure; MAP, mean arterial pressure.