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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’, ‘septic shock’, an...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355573/ https://www.ncbi.nlm.nih.gov/pubmed/25888071 http://dx.doi.org/10.1186/s13054-015-0794-z |
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author | Leone, Marc Asfar, Pierre Radermacher, Peter Vincent, Jean-Louis Martin, Claude |
author_facet | Leone, Marc Asfar, Pierre Radermacher, Peter Vincent, Jean-Louis Martin, Claude |
author_sort | Leone, Marc |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4355573 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43555732015-03-12 Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature Leone, Marc Asfar, Pierre Radermacher, Peter Vincent, Jean-Louis Martin, Claude Crit Care Review 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. BioMed Central 2015-03-10 2015 /pmc/articles/PMC4355573/ /pubmed/25888071 http://dx.doi.org/10.1186/s13054-015-0794-z Text en © Leone et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review Leone, Marc Asfar, Pierre Radermacher, Peter Vincent, Jean-Louis Martin, Claude Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature |
title | Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature |
title_full | Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature |
title_fullStr | Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature |
title_full_unstemmed | Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature |
title_short | Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature |
title_sort | optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355573/ https://www.ncbi.nlm.nih.gov/pubmed/25888071 http://dx.doi.org/10.1186/s13054-015-0794-z |
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