Postresuscitation hypertension is a frequent occurrence following successful resuscitation of severely injured patients with hemorrhagic shock. This combined systolic and diastolic hypertension (> 150/100 mm Hg) was sustained for a minimum of six hours in 20 of 33 severely injured patients treated at Detroit General Hospital during a 20-month period. The cause of postresuscitative hypertension appears to be related to an acute hypervolemic state associated with mobilization of previously sequestered sodium and water and a delay in recovery of adequate renal tubular function. Intravenous administration of normal human serum albumin during resuscitation may contribute to the hypertension by impairing appropriate saline diuresis. This hypertension is associated with increased respiratory insufficiency, hematuria, and central nervous system irritability, which may progress to convulsions. Treatment includes fluid and colloid restriction, and if unresponsive, administration of diuretics and vasodilators.
Ledgerwood AM, Lucas CE. Postresuscitation HypertensionEtiology, Morbidity, and Treatment. Arch Surg. 1974;108(4):531-538. doi:10.1001/archsurg.1974.01350280133022