Acute and Subacute Ischemic Stroke—A Review of Temperature, Blood Pressure and Glycemic Management

Shannon K. Hextrum, B. Bar
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Abstract

T he treatment of ischemic stroke is often divided between acute interventions (endovascular therapy, intravenous tissue plasminogen activator [IV tPA]) and long-term secondary prevention (modifying risk factors, antithrombotic therapy, etc.). There is great variability between practitioners in the medical management of stroke during hospitalization, in part because of confusing and contradictory results in the literature. Temperature management and therapeutic hypothermia is discussed in this review. In regards to blood pressure targets, while permissive hypertension is often recognized as a beneficial strategy in acute stroke, blood pressure reduction is essential for secondary stroke prevention. We review the literature regarding optimal timing of different blood pressure goals. Finally, the limited literature regarding glycemic control in ischemic stroke patients is discussed.
急性和亚急性缺血性卒中——体温、血压和血糖管理的综述
缺血性卒中的治疗通常分为急性干预(血管内治疗,静脉注射组织纤溶酶原激活剂[IV tPA])和长期二级预防(改变危险因素,抗血栓治疗等)。在住院期间中风的医疗管理方面,从业者之间存在很大的差异,部分原因是文献中令人困惑和矛盾的结果。本文讨论了温度管理和治疗性低温。关于血压目标,虽然容许性高血压通常被认为是急性卒中的有益策略,但降低血压对于继发性卒中预防至关重要。我们回顾了关于不同血压目标的最佳时间的文献。最后,对有限的关于缺血性脑卒中患者血糖控制的文献进行了讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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