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Sepsis & Septic Shock

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Recently published in the journal of critical care medicine a systematic review and meta-analysis that aimed to determine whether targeting a higher mean arterial pressure (MAP) in adults with shock results in differences in important patient outcomes compared to a lower MAP.

The study used various data sources and the eligibility criteria included parallel-group randomized controlled trials in adult patients with a diagnosis of shock requiring vasoactive medications. The higher MAP group was required to receive vasoactive medications to target a higher MAP, whereas the lower MAP group received vasoactive medications to target a lower MAP.

Data from six randomized controlled trials were analyzed and showed that targeting a higher MAP (75–85 mm Hg) compared to a lower MAP of 65 mm Hg resulted in no difference in mortality (moderate certainty) but may reduce the risk of undergoing renal replacement therapy in patients with chronic hypertension. Further studies are needed to explore this relationship.

Carayannopoulos, Kallirroi Laiya MD, FRCPC1; Pidutti, Andrew BSc2; Upadhyaya, Yashita MD1; Alshamsi, Fayez MD, FRCPC3; Basmaji, John MD, FRCPC4; Granholm, Anders MD5; Alhazzani, Waleed MD, MSc, FRCPC1,6; Lewis, Kimberley MD, MSc, FRCPC1,6. Mean Arterial Pressure Targets and Patient-Important Outcomes in Critically Ill Adults: A Systematic Review and Meta-Analysis of Randomized Trials*. Critical Care Medicine 51(2):p 241-253, February 2023. | DOI: 10.1097/CCM.0000000000005726

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