How is hypotension treated in basilar artery thrombosis?

Updated: Jan 11, 2019
  • Author: Salvador Cruz-Flores, MD, MPH, FAHA, FCCM, FAAN, FACP, FANA; Chief Editor: Helmi L Lutsep, MD  more...
  • Print
Answer

Patients with hypotension should be treated to normalize the MAP and therefore to improve blood pressure–dependent cerebral blood flow. Every effort should be made to maintain a normal intravascular volume by administering isotonic solutions.

If the MAP continues to be low despite fluid management, vasopressors such as dopamine, dobutamine, or phenylephrine should be used.

Dopamine can cause significant tachycardia; therefore, phenylephrine (Neo-Synephrine) and norepinephrine (Levophed) are the vasopressors of choice after dopamine. Dobutamine should be used with caution and with close monitoring of the cardiac index, because it can often cause vasodilatation and hypotension. Dobutamine is the pressor of choice in patients with congestive heart failure.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!