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Meta-Analysis
. 2024 Mar 16;14(1):6355.
doi: 10.1038/s41598-024-54667-9.

The safety and efficacy of clevidipine for blood pressure management in neurocritical patients: a systematic review and meta-analysis

Monika Widiastuti  1   2   3 , Dewi Yulianti Bisri  4 , Iwan Abdul Rachman  4
Affiliations
Meta-Analysis

The safety and efficacy of clevidipine for blood pressure management in neurocritical patients: a systematic review and meta-analysis

Monika Widiastuti et al. Sci Rep. .

Abstract

We aim to determine the safety and efficacy of clevidipine for neurocritical patients. To comprehensively identify relevant studies, a systematic search strategy was employed using the following keywords: "clevidipine", "high blood pressure", "hypertension", "Neuroscience Intensive Care", "neuro critical", and "neurosurgical patients". Searches were conducted in the Clinicaltrials.gov, PubMed, and EuroPMC databases, with the search extending until September 1, 2023. The primary outcomes of interest were the time needed to achieve the target systolic blood pressure (SBP) and the percentage of time a patient remained within the targeted SBP range. Secondary outcomes included SBP values, duration of intensive care unit (ICU) stay in days, rates of hypotension, and rates of tachycardia. We included five retrospective cohort studies (n = 443), utilizing nicardipine as the primary comparator. Comparison of the time to reach target systolic blood pressure (SBP) revealed no significant difference between medications (SMD = - 1.09, p = 0.33). Likewise, the achieved SBP target showed no notable distinction (RR = 1.15, p = 0.81). However, clevidipine exhibited a slightly higher percentage of time within the target SBP range (SMD = 0.33, p = 0.04), albeit with moderate heterogeneity. Importantly, all included studies were retrospective cohort studies, underscoring the methodological context of the investigation. Clevidipine and the control group were found to be comparable in terms of achieving target SBP. Clevidipine may have a slight advantage in maintaining blood pressure within the desired range, but further research is needed to confirm this finding.

Keywords: Blood pressure; Clevidipine; Hypertension; Neuro critical patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
(a) Forest plot and (b) funnel plot of total time to achieve target SBP.
Figure 3
Figure 3
(a) Forest plot and (b) funnel plot of percentage of time in target SBP.
Figure 4
Figure 4
(a) Forest plot and (b) funnel plot of ICU stay.
Figure 5
Figure 5
(a) Forest plot and (b) funnel plot of post-clevidipine administration SBP.
Figure 6
Figure 6
(a) Forest plot and (b) funnel plot of total events tachycardia.
Figure 7
Figure 7
(a) Forest plot and (b) funnel plot of total events hypotension.
See this image and copyright information in PMC

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