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Related Concept Videos

Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

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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...
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Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

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Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
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Measurement of Blood Pressure01:17

Measurement of Blood Pressure

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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...
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Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

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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.
710
Blood Pressure01:24

Blood Pressure

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The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
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Sites for measruring blood pressure01:21

Sites for measruring blood pressure

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Blood pressure measurement is a fundamental clinical procedure, providing crucial data for assessing cardiovascular health. Among the various sites for this measurement, the brachial and popliteal arteries are predominantly utilized due to their accessibility and the reliability of their readings. This lesson delves into the anatomical significance, methodology, and considerations of measuring blood pressure at these locations.
The Brachial Artery: Primary Site for Blood Pressure Measurement
1.5K
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  11. Fifth Centile Versus 50th Centile Mean Blood Pressure Targets In Pediatric Septic Shock: A Randomized Controlled Trial

Fifth Centile Versus 50th Centile Mean Blood Pressure Targets in Pediatric Septic Shock: A Randomized Controlled Trial

Sachin Shah1, Amita Kaul, Ganesh Shiwarkar

  • 1All authors: Neonatal and Pediatric Intensive Care Services, Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, India.

Critical Care Medicine
|June 13, 2025

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Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
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Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research
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Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock
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View abstract on PubMed

Summary
This summary is machine-generated.

Targeting a lower mean blood pressure (MBP) percentile in pediatric septic shock did not increase 28-day mortality. This approach may safely reduce vasoactive agent use and associated adverse events in critically ill children.

Area of Science:

  • Pediatric critical care medicine
  • Pediatric intensive care
  • Septic shock management

Background:

  • Hypotension is common in pediatric septic shock, necessitating vasoactive agent titration guided by mean blood pressure (MBP).
  • Current guidelines lack consensus on optimal MBP targets (5th vs. 50th percentile) for vasoactive agent titration in pediatric septic shock.

Purpose of the Study:

  • To compare the efficacy and safety of targeting the 5th versus the 50th MBP percentile for vasoactive agent titration in children with septic shock.

Main Methods:

  • A single-center, open-label, randomized noninferiority trial was conducted in a tertiary care pediatric intensive care unit (PICU) in India.
  • 144 children aged 1 month to 16 years with fluid-unresponsive septic shock requiring vasopressors were randomized to either the 5th or 50th MBP percentile target group.
Keywords:
arterial blood pressurehypotensionmean blood pressureseptic shock

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  • Vasopressor treatment was adjusted to maintain the assigned MBP target, with 28-day all-cause mortality as the primary outcome.

    • Main Results:

    • No significant difference in 28-day all-cause mortality was observed between the 5th percentile group (16.9%) and the 50th percentile group (23.2%) (p = 0.41).
    • The 50th percentile group required higher norepinephrine use (85% vs. 67%), longer vasoactive agent duration (30.4 vs. 18.8 days), and had a higher prevalence of acute respiratory distress syndrome (ARDS) (32.8% vs. 16.9%).
    • No significant differences were found in PICU/hospital stay, duration of ventilation, need for continuous renal replacement therapy (CRRT), or vasopressor-related adverse events.

    Conclusions:

    • Targeting a lower MBP (5th percentile) in pediatric septic shock is non-inferior to targeting a higher MBP (50th percentile) regarding 28-day mortality.
    • A lower MBP target may be a safe strategy, potentially reducing vasoactive drug requirements and associated complications like ARDS.
    vasopressors