Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature

Guidelines recommend that a mean arterial pressure (MAP) value greater than 65 mm Hg should be the initial blood pressure target in septic shock, but what evidence is there to support this statement? We searched Pubmed and Google Scholar by using the key words 'arterial pressure', 'se...

Full description

Saved in:
Bibliographic Details
Published in:Critical care (London, England) England), 2015-03, Vol.19 (1), p.101-101, Article 101
Main Authors: Leone, Marc, Asfar, Pierre, Radermacher, Peter, Vincent, Jean-Louis, Martin, Claude
Format: Article
Language:English
Subjects:
Arterial Pressure - drug effects
Blood pressure
Butylamines
Care and treatment
Clinical trials
Comparative analysis
Complications and side effects
Critical Care
Fluids
Health aspects
Humans
Hypertension
Intensive care
Kidneys
Medical research
Medicine, Experimental
Mortality
Norepinephrine - pharmacology
Norepinephrine - therapeutic use
Patients
Phenols
Review
Risk factors
Sepsis
Septic shock
Shock, Septic - drug therapy
Shock, Septic - physiopathology
Variables
Vasoconstrictor Agents - pharmacology
Vasoconstrictor Agents - therapeutic use
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Guidelines recommend that a mean arterial pressure (MAP) value greater than 65 mm Hg should be the initial blood pressure target in septic shock, but what evidence is there to support this statement? We searched Pubmed and Google Scholar by using the key words 'arterial pressure', 'septic shock', and 'norepinephrine' and retrieved human studies published between 1 January 2000 and 31 July 2014. We identified seven comparative studies: two randomized clinical trials and five observational studies. The results of the literature review suggest that a MAP target of 65 mm Hg is usually sufficient in patients with septic shock. However, a MAP of around 75 to 85 mm Hg may reduce the development of acute kidney injury in patients with chronic arterial hypertension. Because of the high prevalence of chronic arterial hypertension in patients who develop septic shock, this finding is of considerable importance. Future studies should assess interactions between time, fluid volumes administered, and doses of vasopressors.
ISSN:1364-8535
1466-609X
1364-8535
1366-609X
DOI:10.1186/s13054-015-0794-z