ArticleCritical care (London, England)2015
A high mean arterial pressure target is associated with improved microcirculation in septic shock patients with previous hypertension: a prospective open label study.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
High Mean Arterial Pressure Target Improves Microcirculation in Septic Shock Patients With Previous Hypertension
The Effect of Fluids and Norepinephrine for Mean Arterial Pressure Titration to Patients' Usual Levels on the Microcirculation of Initial Resuscitated Hypertensive Septic Shock Patients.
Microcirculation After MAP Increase in Septic Shock Patients With Previous Hypertension
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Optimal target blood pressure in critically ill adult patients with vasodilatory shock: A systematic review and meta-analysis.Frontiers in physiology · 2022Pooled it
- Effects of perioperative dexmedetomidine infusion on renal function and microcirculation in kidney transplant recipients: a randomised controlled trial.Annals of medicine · 2022Trial
- Sublingual Sidestream Dark Field (SDF) Microscopy With GlycoCheck Analysis in Individuals With and Without Cardiovascular Risk Factors and Disease.Journal of the American Heart Association · 2026Article
- Renal perfusion pressure: role and implications in critical illness.Annals of intensive care · 2025Review
- The endpoint of fluid responsiveness: is cardiac output enough?Intensive care medicine · 2025Article
- Optimizing Mean Arterial Pressure Targets for Septic Shock Patients With Chronic Hypertension: A Narrative Review.Health science reports · 2025Article
- Association between average mean arterial pressure and 30-day mortality in critically ill patients with sepsis and primary hypertension: a retrospective analysis.Scientific reports · 2024Article
- Review
- Perioperative Acute Kidney Injury: Implications, Approach, Prevention.Advances in anesthesia · 2023Review
- Dose-related effects of norepinephrine on early-stage endotoxemic shock in a swine model.Journal of intensive medicine · 2023Article
- Expert consensus on blood pressure management in critically ill patients.Journal of intensive medicine · 2023Article
- Novelties in the evaluation of microcirculation in septic shock.Journal of intensive medicine · 2023Review
- Microcirculation-guided resuscitation in sepsis: the next frontier?Frontiers in medicine · 2023Review
- Organ Crosstalk in Acute Kidney Injury: Evidence and Mechanisms.Journal of clinical medicine · 2022Review
- Mean Arterial Pressure Goal in Critically Ill Patients: A Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine research · 2022Article
- Prehospital norepinephrine administration reduces 30-day mortality among septic shock patients.BMC infectious diseases · 2022Article
- An Early Predictive Scoring Model for In-Hospital Cardiac Arrest of Emergent Hemodialysis Patients.Journal of clinical medicine · 2021Article
- Acute kidney injury.Nature reviews. Disease primers · 2021Review
- Effects of impaired microvascular flow regulation on metabolism-perfusion matching and organ function.Microcirculation (New York, N.Y. : 1994) · 2021Review
- Article
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12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe effect of mean arterial pressure titration to a higher level on microcirculation in septic shock patients with previous hypertension remains unknown. Our goal is to assess the effect of mean arterial pressure titration to a higher level on microcirculation in hypertensive septic shock patients.
methodsThis is a single-center, open-label study. Hypertensive patients with septic shock for less than 24 hours after adequate fluid resuscitation and requiring norepinephrine to maintain a mean arterial pressure of 65 mmHg were enrolled. Mean arterial pressure was then titrated by norepinephrine from 65 mmHg to the normal level of the patient. In addition to hemodynamic variables, sublingual microcirculation was evaluated by sidestream dark field imaging.
resultsNineteen patients were enrolled in the study. Increasing mean arterial pressure from 65 mmHg to normal levels was associated with increased central venous pressure (from 11 ± 4 to 13 ± 4 mmHg, P = 0.002), cardiac output (from 5.4 ± 1.4 to 6.4 ± 2.1 l/minute, P = 0.001), and central venous oxygen saturation (from 81 ± 7 to 83 ± 7%, P = 0.001). There were significant increases in small perfused vessel density (from 10.96 ± 2.98 to 11.99 ± 2.55 vessels/mm(2), P = 0.009), proportion of small perfused vessels (from 85 ± 18 to 92 ± 14%, P = 0.002), and small microvascular flow index (from 2.45 ± 0.61 to 2.80 ± 0.68, P = 0.009) when compared with a mean arterial pressure of 65 mmHg.
conclusionsIncreasing mean arterial pressure from 65 mmHg to normal levels is associated with improved microcirculation in hypertensive septic shock patients.
trial registrationClinicaltrials.gov: NCT01443494; registered 28 September 2011.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.