Cargando…

Blood Pressure Goals in Critically Ill Patients

Blood pressure goals in the intensive care unit (ICU) have been extensively investigated in large datasets and have been associated with various harm thresholds at or greater than a mean pressure of 65 mm Hg. While it is difficult to perform interventional randomized trials of blood pressure in the...

Descripción completa

Detalles Bibliográficos
Autores principales: Rajkumar, Karuna Puttur, Hicks, Megan Henley, Marchant, Bryan, Khanna, Ashish K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Houston Methodist DeBakey Heart & Vascular Center 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402811/
https://www.ncbi.nlm.nih.gov/pubmed/37547901
http://dx.doi.org/10.14797/mdcvj.1260
_version_ 1785084925038297088
author Rajkumar, Karuna Puttur
Hicks, Megan Henley
Marchant, Bryan
Khanna, Ashish K.
author_facet Rajkumar, Karuna Puttur
Hicks, Megan Henley
Marchant, Bryan
Khanna, Ashish K.
author_sort Rajkumar, Karuna Puttur
collection PubMed
description Blood pressure goals in the intensive care unit (ICU) have been extensively investigated in large datasets and have been associated with various harm thresholds at or greater than a mean pressure of 65 mm Hg. While it is difficult to perform interventional randomized trials of blood pressure in the ICU, important evidence does not support defense of a higher pressure, except in retrospective database analyses. Perfusion pressure may be a more important target than mean pressure, even more so in the vulnerable patient population. In the cardiac ICU, blood pressure targets are tailored to specific cardiac pathophysiology and patient characteristics. Generally, the goal is to maintain adequate blood pressure within a certain range to support cardiac function and to ensure end organ perfusion. Individualized targets demand the use of both invasive and noninvasive monitoring modalities and frequent titration of medications and/or mechanical circulatory support where necessary. In this review, we aim to identify appropriate blood pressure targets in the ICU, recognizing special patient populations and outlining the risk factors and predictors of end organ failure.
format Online
Article
Text
id pubmed-10402811
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Houston Methodist DeBakey Heart & Vascular Center
record_format MEDLINE/PubMed
spelling pubmed-104028112023-08-05 Blood Pressure Goals in Critically Ill Patients Rajkumar, Karuna Puttur Hicks, Megan Henley Marchant, Bryan Khanna, Ashish K. Methodist Debakey Cardiovasc J Review Blood pressure goals in the intensive care unit (ICU) have been extensively investigated in large datasets and have been associated with various harm thresholds at or greater than a mean pressure of 65 mm Hg. While it is difficult to perform interventional randomized trials of blood pressure in the ICU, important evidence does not support defense of a higher pressure, except in retrospective database analyses. Perfusion pressure may be a more important target than mean pressure, even more so in the vulnerable patient population. In the cardiac ICU, blood pressure targets are tailored to specific cardiac pathophysiology and patient characteristics. Generally, the goal is to maintain adequate blood pressure within a certain range to support cardiac function and to ensure end organ perfusion. Individualized targets demand the use of both invasive and noninvasive monitoring modalities and frequent titration of medications and/or mechanical circulatory support where necessary. In this review, we aim to identify appropriate blood pressure targets in the ICU, recognizing special patient populations and outlining the risk factors and predictors of end organ failure. Houston Methodist DeBakey Heart & Vascular Center 2023-08-01 /pmc/articles/PMC10402811/ /pubmed/37547901 http://dx.doi.org/10.14797/mdcvj.1260 Text en Copyright: © 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Review
Rajkumar, Karuna Puttur
Hicks, Megan Henley
Marchant, Bryan
Khanna, Ashish K.
Blood Pressure Goals in Critically Ill Patients
title Blood Pressure Goals in Critically Ill Patients
title_full Blood Pressure Goals in Critically Ill Patients
title_fullStr Blood Pressure Goals in Critically Ill Patients
title_full_unstemmed Blood Pressure Goals in Critically Ill Patients
title_short Blood Pressure Goals in Critically Ill Patients
title_sort blood pressure goals in critically ill patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402811/
https://www.ncbi.nlm.nih.gov/pubmed/37547901
http://dx.doi.org/10.14797/mdcvj.1260
work_keys_str_mv AT rajkumarkarunaputtur bloodpressuregoalsincriticallyillpatients
AT hicksmeganhenley bloodpressuregoalsincriticallyillpatients
AT marchantbryan bloodpressuregoalsincriticallyillpatients
AT khannaashishk bloodpressuregoalsincriticallyillpatients