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Impact of individualized target mean arterial pressure for septic shock resuscitation on the incidence of acute kidney injury: A retrospective cohort study

Annals of Intensive Care Dec 14, 2018

Moman RN, et al. - In this retrospective, single-center cohort study of adult patients, researchers investigated how delta mean arterial pressure (ΔMAP; MAP change between pre-admission minus post-resuscitation) is related to acute kidney injury (AKI) among patients with septic shock. This is the first study analyzing ΔMAP as a risk factor for sepsis-associated-AKI. They defined pre-admission mean arterial pressure (MAP) as the median MAP recorded from 365 to 7 days before admission. Median MAP during the 7th hour after initiating resuscitation was the post-resuscitation MAP. The cohort (N = 233; 55% male) had median (interquartile range [IQR]) age of 71 (58–81) years and the median (IQR) acute physiology, age, chronic health evaluation (APACHE) III score of 81 (66–97). Outcomes suggest a significantly lower incidence of AKI among patients with ΔMAP values in the lowest quartile (ie, patients with post-resuscitation MAP mostly higher than their pre-admission MAP), independent of a history of hypertension.
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