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Related Concept Videos

Blood Pressure01:30

Blood Pressure

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Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the...
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Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

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Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
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Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

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Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
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Measurement of Blood Pressure01:17

Measurement of Blood Pressure

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Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
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Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

796
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
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Neural Regulation of Blood Pressure01:18

Neural Regulation of Blood Pressure

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The neural regulation of blood pressure involves intricate interactions between the autonomic nervous system (ANS) and cardiovascular system, ensuring adequate perfusion of tissues. This regulation primarily occurs through baroreceptor and chemoreceptor reflexes, involving both short-term and long-term mechanisms.
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
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Related Experiment Video

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A Murine Model of Subarachnoid Hemorrhage
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Blood Pressure Control in Traumatic Subdural Hematomas.

David R Hallan1

  • 1Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Cureus
|November 28, 2022
PubMed
Summary

Maintaining systolic blood pressure (SBP) between 100-150mmHg or below 180mmHg in patients with acute traumatic subdural hematoma (SDH) showed no significant difference in 30-day mortality or secondary outcomes. This finding aids in managing SBP goals for traumatic brain injury patients.

Keywords:
blood pressuremapmortalityoutcomessbpsdhsubdural hematomasystolic blood pressuretbitraumatic brain injury

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Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Optimal systolic blood pressure (SBP) management post-traumatic subdural hematoma (SDH) is debated.
  • Higher SBP may improve cerebral perfusion but risks hematoma expansion.
  • Prior research indicates SBP <90mmHg is linked to worse outcomes.

Purpose of the Study:

  • To compare mortality and secondary outcomes between two SBP management strategies in acute traumatic SDH patients.
  • To evaluate the impact of maintaining SBP 100-150mmHg versus SBP <180mmHg.

Main Methods:

  • Retrospective analysis of a de-identified large healthcare database (TriNetX Research Network).
  • Inclusion of patients with acute traumatic SDH and recorded GCS.
  • Propensity-score matching was used to compare cohorts with SBP 100-150mmHg vs. SBP <180mmHg within 24 hours.

Main Results:

  • After matching, 1,243 patients were in each cohort.
  • No statistically significant difference in 30-day mortality (19.76% vs. 16.99%, p=0.0767).
  • No significant differences observed in secondary outcomes including gastrostomy tube placement, craniotomy, VTE, stroke, MI, seizure, falls, or AKI.

Conclusions:

  • Targeting SBP 100-150mmHg or <180mmHg does not significantly alter 30-day mortality in acute traumatic SDH.
  • Neither SBP strategy showed a significant difference in key secondary outcomes.
  • Findings suggest current SBP guidelines may need re-evaluation for this patient population.