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Critical Care
Published in: Critical Care 1/2015

01-12-2015 | Review

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

Authors: Marc Leone, Pierre Asfar, Peter Radermacher, Jean-Louis Vincent, Claude Martin

Published in: Critical Care | Issue 1/2015

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Abstract

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.
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Metadata
Title
Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature
Authors
Marc Leone
Pierre Asfar
Peter Radermacher
Jean-Louis Vincent
Claude Martin
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-015-0794-z

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