Hypoxemic Respiratory Failure, Side Effect, Hypertensive Emergency
Conditions
Brief summary
In the context of postoperative hypertension in the intensive care units, or after resusitation of hypertensive patients, intravenous antihypertensive drugs are often used. Among those drugs, Nicardipine is an effective drug, but with side effects such as inhibition of pulmonary vasoconstriction. Only preclinical studies have investigated the pathophysiology of this mechanism, and no clinical study have proven its clinical relevance. The aim of this study is to establish the incidence of Nicardipine induced hypoxemia and to compare it to another antihypertensive agent, Urapidil.
Detailed description
Prospective observational study in 4 intensive care units in one general hospital and one university hospital. Once Nicardipine or Urapidil infusion is started, data collection of respiratory related information such as type of ventilation, arterial partial pressure of oxygen, blood pressure, cardiac frequency. Statistical analysis for two qualitative variables: Group (Nicardipine or Urapidil) and occurrence or worsening of hypoxemia. Secondary outcoumes analysed such as maximal drop of blood pressure, evolution of the PaO2/FiO2 ratio, length of hospital stay, duration of mechanical ventilation in the ventilated patients. Analysis for different subgroups : Patients with known atelectasis, postoperative of cardiac surgery, neuro-intensive care.
Interventions
Administration of intravenous Nicardipine or Urapidil
Sponsors
University Hospital, Caen
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Major patient * With acute arterial systolic hypertension over 140mmHg * Requiring intravenous administration of one of the two following drugs : Urapidil or Nicardipine
Exclusion criteria
* Patient ventilated Under Nitrogen Monoxyde * Contraindication to Nicardipine or Urapidil * Refusal of the patient or his relatives * Patient treated for pulmonary hypertension
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hypoxemia | During the twelve hours following start of drug infusion | Occurrence of worsening of hypoxemia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of antihypertensive action | During the twelve hours following start of drug infusion | Time before the drop of arterial systolic blood pressure below 140mmHg |
Countries
France
Outcome results
None listed