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Medical management of blood pressure and heart rate in acute type b aortic dissections: a single quaternary Centre perspective

Citation

Tran, Q and Herlihy, D and Tran, V and Puttaswamy, V, Medical management of blood pressure and heart rate in acute type b aortic dissections: a single quaternary Centre perspective, pp. 22-22. ISSN 1742-6731 (2020) [Conference Extract]


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Abstract

Background:

Analgesic and antihypertensive choice in acute type B aortic dissection (TBAD) is still based mainly on personal experience and expert opinion. Objectives: This study examines a patientís course through the emergency department (ED), and choice of analgesia and antihypertensive agents used within an Australian quaternary hospital.

Method:

Between May 2012 and February 2019, 43 patients with acute TBAD managed through the ED at Royal North Shore Hospital (RNSH) were retrospectively analysed via the hospital electronic database.

Results:

For the 43 patients, 93% had an admission systolic BP over 120 mmHg (mean 160 mmHg) and 93% had a HR over 60 bpm (mean 76 bpm). The mean time to be seen by a MO in ED was 12.3 min with a mean length of stay in ED 303 min. The mean time to CTa was 4 h 17 min. 7 different types of analgesia were prescribed in ED with Morphine being the most common (50%). 13 different types of antihypertensive agents were prescribed in ED of which Metoprolol was most frequently used (36%), followed by Hydralazine (11%) and Prazosin (11%). 46% of patients were prescribed 2 antihypertensive agents and 32% with 3 or more. 77% of these patients were transferred to an ICU from ED. Within the ICU, 12 different antihypertensive agents were used where the agent of choice was IV Metoprolol (21%).

Conclusion:

A more standardised approach to the treatment of HR and BP in acute TBAD is imperative in ensuring optimal medical management. This is currently being further analysed though a registry at RNSH.

Item Details

Item Type:Conference Extract
Keywords:emergency, medicine, aortic dissection, blood pressure
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Emergency medicine
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Tran, V (Dr Viet Tran)
ID Code:142103
Year Published:2020
Deposited By:Medicine
Deposited On:2020-12-14
Last Modified:2021-05-21
Downloads:0

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