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Blood Pressure Control in ICH
- Aggressive BP reduction after ICH is currently the focus of an ongoing NINDS study (ATACH Study)
- Current literature recommends that extreme levels of BP after ICH be treated to reduce hematoma expansion
- Mean arterial pressures (MAP) > 130 mmHg should be treated with continous IV medications
- Current recommended medications include labetalol, esmolol, nicardipine, and fenoldopam
- Nitroprusside is avoided by many given its tendency to increase ICP
- Oral and sub-lingual medications are not indicated for immediate and precise BP control
References
Rincon F, Mayer SA. Clinical review: critical care management of spontaneous intracerebral hemorrhage. Crit Care 2008;12:237.