ArticleNature medicine2023
Tissue perfusion pressure enables continuous hemodynamic evaluation and risk prediction in the intensive care unit.
Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- Renal resistive index-guided mean arterial pressure titration in sepsis: a prospective single-center, single-blind, parallel-group randomized controlled trial.Nature communications · 2026Trial
- Twenty-five years of septic shock hemodynamic resuscitation trials: a conceptual perspective.Critical care (London, England) · 2026Review
- Arteriolar Collapse and Haemodynamic Incoherence in Shock: Rethinking Critical Closing Pressure.Journal of personalized medicine · 2026Review
- Venous congestion from a vascular waterfall perspective: reframing congestion as a dynamic Starling resistor phenomenon.Intensive care medicine experimental · 2025Review
- The endpoint of fluid responsiveness: is cardiac output enough?Intensive care medicine · 2025Article
- Point of View: A Holistic Four-Interface Conceptual Model for Personalizing Shock Resuscitation.Journal of personalized medicine · 2025Review
- Ability of diastolic arterial pressure to better characterize the severity of septic shock when adjusted for heart rate and norepinephrine dose.Annals of intensive care · 2025Article
- Clinical outcomes and peripheral tissue oxygen saturation monitoring of the knee region by near-infrared spectroscopy in circulatory shock: a prospective observational cohort study.Critical care (London, England) · 2025Observational
- Electronic vascular conduit for in situ identification of hemadostenosis and thrombosis in small animals and nonhuman primates.Nature communications · 2025Article
- Prebypass Critical Closing Pressure Predicts Acute Kidney Injury After Cardiopulmonary Bypass.Journal of cardiothoracic and vascular anesthesia · 2025Article
- Differential Cardiac Responses after Passive Leg Raising.Journal of clinical monitoring and computing · 2024Article
- Significance of critical closing pressures (starling resistors) in arterial circulation.Critical care (London, England) · 2024Article
- Association between delayed invasive blood pressure monitoring and all-cause mortality in intensive care unit patients with sepsis: a retrospective cohort study.Frontiers in medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
Treatment of circulatory shock in critically ill patients requires management of blood pressure using invasive monitoring, but uncertainty remains as to optimal individual blood pressure targets. Critical closing pressure, which refers to the arterial pressure when blood flow stops, can provide a fundamental measure of vascular tone in response to disease and therapy, but it has not previously been possible to measure this parameter routinely in clinical care. Here we describe a method to continuously measure critical closing pressure in the systemic circulation using readily available blood pressure monitors and then show that tissue perfusion pressure (TPP), defined as the difference between mean arterial pressure and critical closing pressure, provides unique information compared to other hemodynamic parameters. Using analyses of 5,988 admissions to a modern cardiac intensive care unit, and externally validated with 864 admissions to another institution, we show that TPP can predict the risk of mortality, length of hospital stay and peak blood lactate levels. These results indicate that TPP may provide an additional target for blood pressure optimization in patients with circulatory shock.
Indexed as
Identifiers
What OpenQuestion holds
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.