Augmentation of postischemic brain damage by severe intermittent hypertension

Bleyaert, Achiel L.; Sands, P; Šafář, Peter; Nemoto, Edwin M.; Stezoski, S. William; Moossy, John; Rao, Gutti R.

doi:10.1097/00003246-198001000-00008

Cited by 38 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Monkeys subjected to global ischemia and brief episodes of hypertension had higher neurologic deficit scores than animals maintained without hypertension. 3 Rats with focal cerebral hypoxic-ischemic insult had reduced survival time when mean arterial pressure was maintained > 180 mm Hg. 22 We have used the SEP amplitude as a measure of functional neuronal outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of hypertension in the early phase of stroke remains a matter of debate. Some advocate maintaining or even raising the blood pressure 2 to improve cerebral perfusion; others, citing experimental and clinical evidence that suggests transient severe hypertension worsens damage in the injured brain, 3 ' 4 recommend lowering elevated blood pressure. Air embolism is a form of focal cerebral ischemia that occurs after pulmonary barotrauma in divers 56 and in surgical settings.…”

mentioning

confidence: 99%

See 1 more Smart Citation

A brief episode of severe arterial hypertension induces delayed deterioration of brain function and worsens blood flow after transient multifocal cerebral ischemia.

Dutka¹,

Hallenbeck²,

Kochanek³

1987

Stroke

View full text Add to dashboard Cite

T HE early course of cerebral thrombotic or embolic infarction may be associated with a massive stimulation of the sympathetic nervous system that results in an outpouring of catecholamines, transient severe hypertension, and cardiac arrhythmias.' Increased recognition of these phenomena has lead to routine electrocardiographic monitoring of acute stroke patients and aggressive antiarrhythmic treatment. The treatment of hypertension in the early phase of stroke remains a matter of debate. Some advocate maintaining or even raising the blood pressure 2 to improve cerebral perfusion; others, citing experimental and clinical evidence that suggests transient severe hypertension worsens damage in the injured brain, 3 ' 4 recommend lowering elevated blood pressure. Air embolism is a form of focal cerebral ischemia that occurs after pulmonary barotrauma in divers 56 and in surgical settings.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A brief episode of severe arterial hypertension induces delayed deterioration of brain function and worsens blood flow after transient multifocal cerebral ischemia.

Dutka¹,

Hallenbeck²,

Kochanek³

1987

Stroke

View full text Add to dashboard Cite

show abstract

“…Increased pressure levels in this phase are necessary to surpass the no-reflow phenomenon -multifocal and transitory absence of cerebral perfusion 50,51 -and the increase of the intracranial pressure, which provides important resistance to blood flow. However, severe induced hypertension should not be prolonged, because of the secondary myocardial ischemia and the worsening of the cerebral vasogenic edema 52,53 .…”

Section: Cerebral Resuscitationmentioning

confidence: 99%

Cardiopulmonary resuscitation: update, controversies and new advances

Zago¹,

Nunes²,

Cunha³

et al. 1999

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardiopulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjust-ment of drug doses, new techniques--measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure--and new drugs under research.

show abstract

“…39 44 45 69 78 Severe hypertension may also be an underlying cause for poor cerebral outcome. 10 Although direct intracardiac injection still has its advocates, it is now regarded as a last resort, only to be used when all other methods have failed.…”

Section: Circulationmentioning

confidence: 99%

Paediatric and neonatal life support

Zideman

1997

British Journal of Anaesthesia

View full text Add to dashboard Cite

Resuscitation of infants and children is different from adult resuscitation. Although there may be many similarities in the methodologies used in the resuscitation procedures with those used in adults, paediatric life support is governed by the fact that it begins from a different starting point. Adult sequences are based on the observation that the majority of cases are primarily cardiac in origin; arrest is therefore rapid and immediate in onset giving little or no warning of occurrence and usually requiring rapid defibrillation to achieve any measure of success. In infants and children the cause is usually primarily a respiratory event which leads to the final cardiac arrest if not recognized and dealt with promptly. 43 46 95 96 105 Primary cardiac arrest in children is rare and ventricular fibrillation and ventricular tachycardia have been reported in less than 15% of the young. 4 40 64 The aetiology and pathogenesis of sudden death in this age group is therefore important. Many children have a relatively long "pre-arrest" phase, cardiac arrest signalling the end of a progressive physiological decline. It could be argued that in such events many deaths could be prevented by early recognition and aggressive therapy in this "pre-arrest" phase but, unfortunately, some remain irreversible despite all efforts. Trauma is the one cause of cardiac arrest that occurs in both children and adults and is the most common cause of death in the first four decades of life. It could be argued that trauma is preventable and, more importantly, cardiac arrest secondary to trauma can in some cases be prevented by careful correct management of the airway, breathing and circulation of the trauma victim before managing the secondary injuries. The outcome of paediatric life support is disappointingly low with survival rates between 3 and 17%. 23 25 32 43 46 57 64 71 82 90 98 105 These poor survival results are even more dismal when the majority show significant neurological impairment after arrest. The variability in results is attributed to whether the primary event was respiratory in nature, which has a better outcome, 25 55 98 or a primary cardiac event, which has a worse prognosis. 25 32 72 Furthermore,

show abstract

Augmentation of postischemic brain damage by severe intermittent hypertension

Cited by 38 publications

References 0 publications

A brief episode of severe arterial hypertension induces delayed deterioration of brain function and worsens blood flow after transient multifocal cerebral ischemia.

A brief episode of severe arterial hypertension induces delayed deterioration of brain function and worsens blood flow after transient multifocal cerebral ischemia.

Cardiopulmonary resuscitation: update, controversies and new advances

Paediatric and neonatal life support

Contact Info

Product

Resources

About