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BP Control in IVH with Herniation

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Hey guys,

ED resident here and wanted you to drop some knowledge on me. Recently had patient with IVH who was herniating. BP 220s systolic. Initially planned to do a Cardene drip for SBP goal 140-160 but the attending brought up the point of needing the BP to perfuse since the ICP was elevated.

How do you guys handle this situation?

I can see the higher pressure making the bleed worse, but also can see their point of dropping CPP but dropping the MAP.

Obviously can't fix this in the...

BP Control in IVH with Herniation

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