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Related Experiment Videos

Pressor therapy in acute ischemic stroke: systematic review.

Amit K Mistri1, Thompson G Robinson, John F Potter

  • 1University of Leicester, The Glenfield Hospital, Leicester, UK. chhips@le.ac.uk

Stroke
|May 6, 2006
PubMed
Summary

Low blood pressure after acute stroke may harm patients. Inducing blood pressure elevation in acute ischemic stroke could improve blood flow, but more research is needed to confirm safety and benefits.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Critical Care

Background:

  • Systolic blood pressure (SBP) below 140 mm Hg occurs in 18-25% of acute stroke patients.
  • Low SBP post-stroke is linked to increased mortality and disability.
  • Elevating blood pressure (BP) might enhance perfusion to the ischemic penumbra.

Purpose of the Study:

  • To review existing literature on blood pressure elevation strategies in acute stroke.
  • To assess the feasibility and tolerability of pressor therapy in acute stroke patients.

Main Methods:

  • A structured search identified all articles on BP elevation in acute stroke.
  • Two reviewers independently screened 12 relevant publications.
  • Included studies involved 319 patients, primarily using phenylephrine or volume expansion.

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Main Results:

  • All identified studies focused on acute ischemic stroke; none on hemorrhagic stroke.
  • Pressor therapy in acute stroke appears feasible and well-tolerated in small trials.
  • No meta-analysis was possible due to small sample sizes and varied criteria; clinical outcomes remain unknown.

Conclusions:

  • Theoretical basis exists for BP elevation to improve penumbral blood flow in acute ischemic stroke.
  • Current trials are small with inconclusive results regarding safety and efficacy.
  • Further research, including ongoing trials, is necessary to clarify the benefits and risks of pressor therapy.