Key result
Targeting a mean arterial pressure of 80 to 85 mmHg compared to 65 to 70 mmHg in patients with septic shock did not significantly affect 28-day mortality (36.6% vs 34.0%, HR 1.07).
Why the study?
Does targeting a higher mean arterial pressure (80 to 85 mmHg) reduce mortality in patients with septic shock compared to a standard target (65 to 70 mmHg)?
RCT (n=776)
Open-label
Stratified
Yes
Does targeting a higher mean arterial pressure (80 to 85 mmHg) reduce mortality in patients with septic shock compared to a standard target (65 to 70 mmHg)?
Targeting a higher mean arterial pressure (80-85 mmHg) in septic shock does not improve 28-day or 90-day mortality compared to a standard target (65-70 mmHg), though it may reduce the need for renal replacement therapy in patients with chronic hypertension at the cost of increased atrial fibrillation.
No mortality benefit with higher MAP targets in septic shock; leaves open renal and AF effects in hypertensive subgroups for targeted trials.
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Kato et al. (2015) conducted an RCT in Septic shock (n=776). High mean arterial pressure target vs. Low mean arterial pressure target (65 to 70 mmHg) was evaluated on Death from any cause by 28 days after inclusion (HR 1.07, 95% CI 0.84 to 1.38, p=0.57). Targeting a mean arterial pressure of 80 to 85 mmHg compared to 65 to 70 mmHg in patients with septic shock did not significantly affect 28-day mortality (36.6% vs 34.0%, HR 1.07).
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