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Target blood pressure for hypotensive resuscitation
Geng-Shiau Lin1, Tzung-Hsin Chou, Cheng-Yi Wu
1Department of Emergency Medicine, National Taiwan University, College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
Injury
|March 16, 2013
Summary
Hypotensive resuscitation in trauma patients may benefit from a mean arterial pressure (MAP) target of 60mmHg. This study suggests 60mmHg MAP is a viable target for resuscitation during hemorrhagic shock.
Area of Science:
- Trauma and Emergency Medicine
- Physiology
- Resuscitation Science
Background:
- Hypotensive resuscitation has shown promise in managing hemorrhagic shock.
- The optimal target for mean arterial pressure (MAP) during resuscitation remains under investigation.
Purpose of the Study:
- To investigate the efficacy of various target MAPs for hypotensive resuscitation in uncontrolled hemorrhagic shock.
- To determine the ideal MAP for fluid resuscitation in trauma-induced hemorrhagic shock.
Main Methods:
- Eighty rats were randomized into 8 groups, each with a different target MAP (40-90mmHg, control, sham).
- Measurements included blood pressure, lactate, hematocrit, fluid intake, blood loss, and cytokine levels over 300 minutes.
- Effects of target MAPs on resuscitation outcomes were observed.
Main Results:
- Higher MAP targets (70-90mmHg) led to increased blood loss and reduced hematocrit and inflammatory cytokine production.
- Lower MAP targets (40-60mmHg) resulted in less blood loss but decreased animal survival.
- No significant differences in key outcomes were observed between MAP targets of 60mmHg and 70mmHg.
Conclusions:
- A MAP target of 60mmHg warrants consideration for human trials in hypotensive resuscitation.
- This MAP may offer a balance between minimizing blood loss and maintaining adequate resuscitation.
- Further evaluation in human studies is recommended for trauma patients in hemorrhagic shock.
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