在非心脏外科手术中,低血压与高血压避免策略在30日主要血管并发症方面没有差异
1NYU Grossman School of Medicine, New York, New York, USA (M.T.).
Annals of internal medicine
|July 31, 2023
概括
在非心脏手术期间避免低血压在预防主要心脏不良事件方面并不优于避免高血压. 这两种策略在这个大型国际试验中表现出类似的结果.
科学领域:
- 麻醉学 麻醉学
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 在非心脏手术期间,手术内血压管理至关重要.
- 目前的指南提供了关于最佳血压目标的不同建议.
- 在POISE-3试验中,研究了两种不同的术后血压管理策略.
研究的目的:
- 为了比较低血压避免策略与高血压避免策略的疗效.
- 为了确定哪种策略导致较低的心脏或脑血管重大不良事件的发生率.
- 评估血压管理对非心脏外科手术患者结果的影响.
主要方法:
- 国际,多中心,随机对照试验.
- 涉及的是接受非心脏手术的患者.
- 将旨在避免低血压 (平均动脉压≥65 mmHg) 的策略与旨在避免高血压 (平均动脉压≤80 mmHg) 的策略进行比较.
主要成果:
- 主要结局 (主要心脏或脑血管不良事件的组合) 发生在低血压避免组的10.0%患者和高血压避免组的9.7%患者中.
- 两种策略之间没有观察到关于主要结果的显著差异.
- 二次结果,包括中风和心肌梗塞,也没有显著差异.
结论:
- 在接受非心脏手术的患者中,低血压避免或高血压避免策略在减少主要心脏或脑血管不良事件方面都没有优势.
- 这些发现表明,目前的血压管理策略可能需要重新评估.
- 需要进一步的研究来确定非心脏手术期间最佳的血压管理.
相关概念视频
Pre-Procedural Guidelines for Assessing Blood Pressure
595
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
595
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Hypertension V: Nursing Management
11
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
11
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Cardiac Catheterization IV: Nursing Management
62
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
62
Alterations in Blood Pressure
1.3K
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
1.3K


