神经关键护理中的实践模式变化 血压控制 揭示了改善长期高血压控制的机会
Megan Kennelly1, Andrew J Webb2, Sophie E Ack1
1Department of Neurology, Mass General Brigham, Boston.
Neurology. Clinical practice
|March 27, 2025
概括
神经临界护理转移时的高血压预测出院时和两年内不受控制的血压. 在住院期间改善血压控制可能会降低长期心血管风险.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 失控的高血压是心血管事件的重要危险因素,如心脏病发作和中风.
- 门诊血压控制率往往低于最佳水平,这凸显了需要有效的住院治疗策略的需要.
- 神经临床护理设置为严格管理血压目标提供了独特的机会.
研究的目的:
- 为了研究神经临界护理期间血压 (BP) 控制与随后的高血压状态之间的联系.
- 为了确定神经科学重症监护室 (NeuroICU) 中的血压控制是否预测出院时和出院后长达两年的不受控制的高血压.
主要方法:
- 一个回顾性队列研究的成年患者入院NeuroICU在两个中心.
- 高血压的定义是静脉血压≥140mm Hg或心压血压≥90mm Hg.
- 多变量模型评估了NeuroICUBP控制和高血压在出院/两年随访期间之间的联系,并对共变量和治疗强度进行了调整.
主要成果:
- 在10836名符合条件的入院者中,28.3%在出院时患有高血压.
- 在NeuroICU转移时缩血压增加10mmHg与出院时失控高血压的几率增加1.60倍相关.
- 在NeuroICU转移时高血压独立预测出院后无法控制的高血压,并且持续24个月,无论诊断,病史或治疗强度如何.
结论:
- 在神经关键治疗期间发现的高血压是持续失控血压的强有力的预测因素.
- 住院治疗,特别是神经临床护理,为优化血压管理提供了一个关键的窗口.
- 需要进一步的研究来确认在神经临床护理期间加强血压控制是否会带来持续的长期益处.
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