Category: Fellows Posters
Clevidipine is an intravenous, rapid-acting, easily titratable dihydropyridine calcium channel blocker commonly used in the tight management of blood pressure in patients during the acute phase of neurologic emergencies. Once patients are hemodynamically stable, patients are transitioned from clevidipine to oral antihypertensives. An issue with clevidipine use is rebound hypertension upon discontinuation despite initiation of oral antihypertensive medications. The purpose of this retrospective chart review is to identify oral antihypertensives that minimize the rate of rebound hypertension, which to our knowledge has not been evaluated before.
This study is a retrospective chart review of patients admitted to the neuro-intensive care unit from February 2019 to August 2019. Patients included are those aged 18 years or older and admitted for ischemic stroke, intracranial hemorrhage, or subarachnoid hemorrhage and received clevidipine for blood pressure management. Patients excluded include any admitting diagnosis to the neuro-ICU other than the aforementioned conditions or the use of nicardipine at any time. The primary endpoint is the successful maintenance of blood pressure to goal 8 hours after discontinuation of clevidipine and transition to an oral calcium channel blocker. Secondary endpoints include hospital and ICU length of stay, reinitiation of clevidipine within 24 hours if warranted, classification of oral antihypertensive and other pertinent data (including drug, dose, and frequency), use of additional rescue IV antihypertensives, and duration of clevidipine use. Statistical analyses used will include the Mann-Whitney U test and the two sample t-test.