Hypertension in older adults: assessment, management, and challenges. Duplicate citations


J Cardiothorac Vasc Anesth ; 35 4 :Apr.

hypertension in older adults: assessment, management, and challenges

Article En MEDLINE ID: mdl Hemodynamic conditions with reduced systemic vascular resistance commonly are observed in patients undergoing cardiac surgery and may range from moderate reductions in vascular tone, as a side effect of general anesthetics, to a profound vasodilatory syndrome, often referred to as vasoplegic shock.

Therapy with vasopressors is an important pillar in the treatment of these conditions.

hypertension in older adults: assessment, management, and challenges

There is limited guidance on the appropriate choice of vasopressors to restore and optimize systemic vascular tone in patients undergoing cardiac surgery.

A panel of experts in the field convened to develop statements and evidence-based recommendations on clinically relevant management on the use of vasopressors in cardiac gyógyszer hipertónia receptek patients, using a critical appraisal of the literature following the GRADE system and a modified Delphi process. The authors unanimously and strongly recommend against hypertension in older adults: assessment dopamine for treating post-cardiac surgery vasoplegic shock and against using methylene blue for purposes other than a rescue therapy.

The authors unanimously and weakly recommend that clinicians consider early addition of a second vasopressor norepinephrine or vasopressin if adequate and challenges tone cannot be restored by a monotherapy with either norepinephrine or vasopressin and to consider using vasopressin as a first-line vasopressor or to add vasopressin to norepinephrine in cardiac surgical patients with pulmonary hypertension or right-sided heart dysfunction.

hypertension in older adults: assessment, management, and challenges