• Celine S Gathier, IJsbrand A J Zijlstra, RinkelGabriel J EGJEDepartment of Neurology and Neurosurgery and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands., T Katrien J Groenhof, Dagmar Verbaan, Bert A Coert, MüllerMarcella C AMCADepartment of Intensive Care, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands., Walter M van den Bergh, SlooterArjen J CAJCDepartment of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium., and EijkemansMarinus J CMJCJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands..
• Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Neurology and Neurosurgery and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. Electronic address: c.s.gathier-4@umcutrecht.nl.
• J Crit Care. 2022 Dec 1; 72: 154124154124.

Introduction And ObjectiveBlood pressure is presumably related to rebleeding and delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (aSAH) and could serve as a target to improve outcome. We assessed the associations between blood pressure and rebleeding or DCI in aSAH-patients.Materials And MethodsIn this observational study in 1167 aSAH-patients admitted to the intensive care unit (ICU), adjusted hazard ratio's (aHR) were calculated for the time-dependent association of blood pressure and rebleeding or DCI. The aHRs were presented graphically, relative to a reference mean arterial pressure (MAP) of 100 mmHg and systolic blood pressure (sBP) of 150 mmHg.ResultsA MAP below 100 mmHg in the 6, 3 and 1 h before each moment in time was associated with a decreased risk of rebleeding (e.g. within 6 h preceding rebleeding: MAP = 80 mmHg: aHR 0.30 (95% confidence interval (CI) 0.11-0.80)). A MAP below 60 mmHg in the 24 h before each moment in time was associated with an increased risk of DCI (e.g. MAP = 50 mmHg: aHR 2.59 (95% CI 1.12-5.96)).ConclusionsOur results suggest that a MAP below 100 mmHg is associated with decreased risk of rebleeding, and a MAP below 60 mmHg with increased risk of DCI.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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