title: Clevidipine Versus Nicardipine for Acute Blood Pressure Reduction in a Neuroscience Intensive Care Population.
abstract: Currently, a lack of published literature exists regarding the use of clevidipine in the neuroscience population. This agent may be preferred in some patients because of its short half-life, potentially leading to more narrow blood pressure (BP) control in comparison with other agents. The purpose of this study was to compare the difference in time to achieve target systolic blood pressure (SBP) goals with clevidipine versus nicardipine infusions in patients admitted to the neuroscience intensive care unit (NSICU) at our institution.
  
  
  
  A retrospective review was performed on patients receiving clevidipine or nicardipine infusions while in the NSICU between July 1, 2011 and June 30, 2014. Patients were matched based on indication for BP lowering and target SBP. Primary endpoints included time to target SBP and percentage of time within target BP range.
  
  
  
  Of the 57 patients included in the study, the median time to target SBP was 30 min in the clevidipine group and 46 min in the nicardipine group (p = 0.13). The percentage of time spent within target BP range was 79 versus 78% (p = 0.64). Clevidipine administration resulted in significantly less volume administered per patient versus nicardipine (530 vs. 1254 mL, p = 0.02).
  
  
  
  There were no statistically significant differences in acute BP management between the two agents; however, there was a trend toward shorter time to target and significantly less volume administered in the clevidipine group. Either agent should be considered a viable option in a NSICU population.
authors.affiliation: Banner-University Medical Center, Tucson, AZ, USA. jacqueline.finger@bannerhealth.com.
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Finger
authors.affiliation: Virginia Commonwealth University Health System, Richmond, VA, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kurczewski
authors.affiliation: Department of Pharmacotherapy & Outcomes Science and Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Gretchen M
authors.initials: GM
authors.lastname: Brophy
mesh_terms: D000368:Aged; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology*; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000628:therapy*; D009529:Nicardipine / Q000008:administration & dosage / Q000494:pharmacology*; D011725:Pyridines / Q000008:administration & dosage / Q000494:pharmacology*; D012189:Retrospective Studies
chemical_list: D002121:Calcium Channel Blockers; D011725:Pyridines; C118563:clevidipine; D009529:Nicardipine
keywords: Antihypertensive; Blood pressure; Clevidipine; Neurocritical care; Nicardipine