Why the study?
Appropriate blood pressure targets in the ICU remain nuanced, with evidence not supporting higher pressure targets and requiring individualized targets tailored to cardiac pathophysiology and organ perfusion.
What are the appropriate blood pressure targets for critically ill patients in the ICU and cardiac ICU?
What are the appropriate blood pressure targets for critically ill patients in the ICU and cardiac ICU?
This review emphasizes the importance of individualized blood pressure targets and perfusion pressure monitoring in the cardiac ICU to ensure end-organ perfusion.
Answers are grounded in this paper and cite their sources.
May support perfusion pressure over mean arterial pressure targets in ICU; hypothesis-generating and requires prospective validation.
Blood pressure goals in the intensive care unit (ICU) have been extensively investigated in large datasets and have been associated with various harm thresholds at or greater than a mean pressure of 65 mm Hg. While it is difficult to perform interventional randomized trials of blood pressure in the ICU, important evidence does not support defense of a higher pressure, except in retrospective database analyses. Perfusion pressure may be a more important target than mean pressure, even more so in the vulnerable patient population. In the cardiac ICU, blood pressure targets are tailored to specific cardiac pathophysiology and patient characteristics. Generally, the goal is to maintain adequate blood pressure within a certain range to support cardiac function and to ensure end organ perfusion. Individualized targets demand the use of both invasive and noninvasive monitoring modalities and frequent titration of medications and/or mechanical circulatory support where necessary. In this review, we aim to identify appropriate blood pressure targets in the ICU, recognizing special patient populations and outlining the risk factors and predictors of end organ failure.
No takes yet. Share an insight, caveat, or question.
Rajkumar et al. (2023) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: