Efficacy of low-dose nicardipine for emergent treatment of severe postpartum hypertension in maternal intensive care units: An observational study.

OBJECTIVES To investigate the efficacy of low-dose intravenous nicardipine for emergent management of severe postpartum hypertension in maternal intensive care units (ICUs). STUDY DESIGN The initial dosage of nicardipine was dependent upon patient systolic blood pressure (SBP). Patients with an SBP of 160-179 mmHg received an initial dosage of 2 mg/h, and 4 mg/h was administered to patients where SBP exceeded 180 mmHg. MAIN OUTCOME MEASURES The efficacy of nicardipine was evaluated by measuring the time interval for achieving the target blood pressure, and its safety was determined by the incidence of severe adverse maternal effects. RESULTS A total number of 101 patients were admitted to the ICU for severe postpartum hypertension and treated with nicardipine. For patients with an SBP of 160-179 mmHg (n = 28), the interval was 14.04 ± 11.00 min (mean ± SD) for achieving the target blood pressure, and the frequency for adjusting the nicardipine dosage was 1.46 ± 1.17. For patients with an SBP ≥ 180 mmHg (n = 73), the interval was 30.75 ± 16.15 min, and the frequency was 1.62 ± 1.38. Three patients with an SBP ≥ 240 mmHg and/or a diastolic blood pressure (DBP) ≥ 130 mmHg failed to achieve the target blood pressure within 60 min. No severe adverse effects occurred in this study. CONCLUSIONS Our findings showed that low-dose nicardipine could be used to lower elevated blood pressure safely and rapidly in patients admitted to the ICU for severe postpartum hypertension.