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ICU Management of Hypertension

ICU Management of Hypertension is a topic covered in the Pocket ICU Management.

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First Things First (assess & treat for the following)

  • Definitions
    • Hypertension (HTN), as described by JNC VII, is BP >140/90 on more than one occasion. Hypertensive urgency is severe HTN (typically systolic >180 or diastolic BP >120) without symptoms or end-organ damage (ie, without evidence of CNS, CV, renal or retinal dysfunction).
    • Hypertensive emergency: an acute, life-threatening event requiring immediate treatment
      • Textbook definition: diastolic BP >140 accompanied by end-organ damage
      • The rate of increase in BP can be just as important as absolute BP numbers, particularly in previously normotensive pts.
      • Malignant hypertension is a subtype of HTN emergency, with findings typically focused on the eye.
      • HTN encephalopathy is another subtype of HTN emergency centering on cerebral edema and its associated findings.
  • Differential includes:
    • Essential HTN
    • Renal (acute glomerulonephritis, vasculitis, renal artery stenosis)
    • CNS (head injury, hemorrhage)
    • Eclampsia
    • High catecholamine states (pheochromocytoma, drug ingestions such as cocaine & amphetamines, rebound HTN from stopping antihypertensives, tyramine ingestion with MAO inhibitors & postop HTN)
    • Miscellaneous (medicine noncompliance, severe burns, severe pain, or autonomic dysfunction from spinal cord injury or Guillain-Barre syndrome)

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Last updated: April 23, 2010


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TY - ELEC T1 - ICU Management of Hypertension ID - 534201 Y1 - 2010/04/23/ BT - Pocket ICU Management UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534201/all/ICU_Management_of_Hypertension PB - PocketMedicine.com, Inc DB - Anesthesia Central DP - Unbound Medicine ER -