ArticleIntensive care medicine2018
The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients.
Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 8 of them syntheses that pooled it.
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Who cites it
137 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Definitions for Vasoplegia Associated With On-Pump Cardiac Surgery: A Systematic Review With Meta-Analysis.Critical care explorations · 2025Pooled it
- Mortality effect of higher versus lower blood pressure targets in vasodilatory shock: an updated systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Hypotension during intensive care stay and mortality and morbidity: a systematic review and meta-analysis.Intensive care medicine · 2024Pooled it
- Propofol and survival: an updated meta-analysis of randomized clinical trials.Critical care (London, England) · 2023Pooled it
- Accuracy and precision of oscillometric noninvasive blood pressure measurement in critically ill patients: systematic review and meta-analysis.Anaesthesiology intensive therapy · 2022Pooled it
- Optimal target blood pressure in critically ill adult patients with vasodilatory shock: A systematic review and meta-analysis.Frontiers in physiology · 2022Pooled it
- Reduced exposure to vasopressors through permissive hypotension to reduce mortality in critically ill people aged 65 and over: the 65 RCT.Health technology assessment (Winchester, England) · 2021Pooled it
- Acute kidney injury in trauma patients admitted to the ICU: a systematic review and meta-analysis.Intensive care medicine · 2019Pooled it
- Control of mean arterial pressure using a closed-loop system for norepinephrine infusion in severe brain injury patients: the COMAT randomized controlled trial.Journal of clinical monitoring and computing · 2024Trial
- Initiating angiotensin II at lower vasopressor doses in vasodilatory shock: an exploratory post-hoc analysis of the ATHOS-3 clinical trial.Critical care (London, England) · 2023Trial
- Trial
- Effects of very early start of norepinephrine in patients with septic shock: a propensity score-based analysis.Critical care (London, England) · 2020Trial
- Easy DAO2 index: a novel hemodynamic risk factor for predicting mortality in surgical and critically ill patients.Korean journal of anesthesiology · 2026Observational
- Crossover effect: causal machine learning reveals opposing mortality responses to mean arterial pressure targets among phenotypically distinct hypertensive patients with septic shock.Internal medicine journal · 2026Article
- Alarm configuration and adherence to prescribed mean arterial pressure targets in the intensive care unit: A multicentre pre-post evaluation.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Prognostic associations of urine output in AKI and dialysis vintage in ESKD at continuous kidney replacement therapy initiation in ICU patients.Journal of intensive care · 2026Article
- Intraoperative Hypotension and Risk of Cuff Blood Pressure Inaccuracy.medRxiv : the preprint server for health sciences · 2026Article
- Targeting and monitoring mean arterial pressure in critical illness: A mixed-methods service evaluation.Journal of the Intensive Care Society · 2026Article
- Performance of the Hypotension Prediction Index as an indicator of hypotensive haemodynamic instability in surgical patients.Perioperative medicine (London, England) · 2026Article
- Is arterial hypotension the real enemy in septic shock or is it just cosmetic?Annals of intensive care · 2026Article
77 more citing papers are in PubMed but not listed here.
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeCurrent guidelines recommend maintaining a mean arterial pressure (MAP) ≥ 65 mmHg in septic patients. However, the relationship between hypotension and major complications in septic patients remains unclear. We, therefore, evaluated associations of MAPs below various thresholds and in-hospital mortality, acute kidney injury (AKI), and myocardial injury.
methodsWe conducted a retrospective analysis using electronic health records from 110 US hospitals. We evaluated septic adults with intensive care unit (ICU) stays ≥ 24 h from 2010 to 2016. Patients were excluded with inadequate blood pressure recordings, poorly documented potential confounding factors, or renal or myocardial histories documented within 6 months of ICU admission. Hypotension exposure was defined by time-weighted average mean arterial pressure (TWA-MAP) and cumulative time below 55, 65, 75, and 85 mmHg thresholds. Multivariable logistic regressions determined the associations between hypotension exposure and in-hospital mortality, AKI, and myocardial injury.
resultsIn total, 8,782 patients met study criteria. For every one unit increase in TWA-MAP < 65 mmHg, the odds of in-hospital mortality increased 11.4% (95% CI 7.8%, 15.1%, p < 0.001); the odds of AKI increased 7.0% (4.7, 9.5%, p < 0.001); and the odds of myocardial injury increased 4.5% (0.4, 8.7%, p = 0.03). For mortality and AKI, odds progressively increased as thresholds decreased from 85 to 55 mmHg.
conclusionsRisks for mortality, AKI, and myocardial injury were apparent at 85 mmHg, and for mortality and AKI risk progressively worsened at lower thresholds. Maintaining MAP well above 65 mmHg may be prudent in septic ICU patients.
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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.