Related Experiment Video
Updated: Mar 30, 2026
08:45
Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
1.6K
Personalizing blood pressure management in septic shock
Ryotaro Kato1, Michael R Pinsky2
1Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 606 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA. ryotarokato@gmail.com.
Annals of Intensive Care
|November 18, 2015
Summary
Targeting mean arterial pressure (MAP) in sepsis resuscitation requires individualized approaches. For sepsis patients without hypertension, aim for 65-70 mmHg, while those with chronic hypertension may benefit from 80-85 mmHg.
Area of Science:
- Critical Care Medicine
- Hemodynamics
- Sepsis Pathophysiology
Background:
- Sepsis resuscitation involves optimizing hemodynamic parameters.
- Mean arterial pressure (MAP) is a key indicator of perfusion but requires careful interpretation.
Purpose of the Study:
- To review evidence for specific mean arterial pressure (MAP) targets during sepsis resuscitation.
- To guide individualized MAP targets based on patient characteristics and organ perfusion needs.
Main Methods:
- Systematic review of clinical data on MAP targeting in sepsis.
- Analysis of organ-specific perfusion pressure requirements.
Main Results:
- A MAP of 65-70 mmHg is a reasonable initial target for sepsis patients without chronic hypertension.
- Higher MAP targets (80-85 mmHg) may reduce renal injury in hypertensive patients but increase arrhythmia risk.
- MAP alone is insufficient for assessing organ perfusion, especially with elevated intracranial, intra-abdominal, or tissue pressures.
Conclusions:
- Individualized MAP targets are crucial in sepsis resuscitation.
- Organ-specific perfusion pressures (e.g., brain, renal, splanchnic) should guide MAP titration.
- MAP should be adjusted based on organ function and tissue perfusion measures beyond a general target.
Related Concept Videos
01:25Errors occurring during blood pressure monitoring
1.8K
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
1.8K
01:24Blood Pressure Imbalances and Circulatory Shock
1.8K
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
1.8K
01:23Hypertension V: Nursing Management
647
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
647
01:28Special considerations while measuring blood pressure
1.5K
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
1.5K
01:28Factors affecting Blood pressure
7.7K
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
7.7K
01:17Measurement of Blood Pressure
3.9K
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
3.9K