Oxygenation effects of antihypertensive agents in intensive care: a prospective comparative study of nicardipine and urapidil

Overview & Synopsis

Introduction: the aim of this study is to compare the impact of administring intravenous antihypertensive agents on the oxygenation of patients in intensive care units between Nicardipine and Urapidil. Study design: prospective, observational, bicentric study. Patients and methods: 197 patients hospitalized in intensive care units who required intravenous antihypertive agents with Nicardipine or Urapidil were included in this study between November 2021 and November 2023. Ninety-eight of these patients received Nicardipine and 99 received Urapidil. During this period, we assessed the occurence or worsening of hypoxemia within the first 12 hours following the treatment’s onset using a composit criterion to compare the incidence. Results: we found a significant difference in the primary outcome between the two groups, where 65 (66%) of the patients receiving Nicardipine compared to 32 (32%) of the patient receiving Urapidil (relative risk [RR] 2.05, confidence interval [CI] [1.48-2.82], p < 0.001). Conclusion: the use of Nicardipine is significantly associated with the occurence or worsening of hypoxemia compared to Urapidil in patients hospitalized in intensive care units. These results suggest cautions consideration of the patient’s respiratory status should be exercised when initiating intravenous Nicardipine.