Mean arterial pressure and mortality in patients with distributive shock: a retrospective analysis of the MIMIC-III database

Jean Louis Vincent, Nathan N.D. Nielsen, Nathan N.I. Shapiro, Margaret M.E. Gerbasi, Aaron Grossman, Robin Doroff, Feng Zeng, Paul M. Young and James Russell

ULB Institutional Repository from ULB -- Universite Libre de Bruxelles

Abstract: Background: Maintenance of mean arterial pressure (MAP) at levels sufficient to avoid tissue hypoperfusion is a key tenet in the management of distributive shock. We hypothesized that patients with distributive shock sometimes have a MAP below that typically recommended and that such hypotension is associated with increased mortality. Methods: In this retrospective analysis of the Medical Information Mart for Intensive Care (MIMIC-III) database from Beth Israel Deaconess Medical Center, Boston, USA, we included all intensive care unit (ICU) admissions between 2001 and 2012 with distributive shock, defined as continuous vasopressor support for ≥ 6 h and no evidence of low cardiac output shock. Hypotension was evaluated using five MAP thresholds: 80, 75, 65, 60 and 55 mmHg. We evaluated the longest continuous episode below each threshold during vasopressor therapy. The primary outcome was ICU mortality. Results: Of 5347 patients with distributive shock, 95.7%, 91.0%, 62.0%, 36.0% and 17.2%, respectively, had MAP 0 to 2 h. Episodes of prolonged hypotension were associated with higher mortality.

Keywords: Acute circulatory failure; ICU mortality; Mean arterial pressure; Multiple organ failure (search for similar items in EconPapers)
Date: 2018-12
Note: SCOPUS: ar.j
References: View complete reference list from CitEc
Citations:

Published in: Annals of intensive care (2018) v.8 n° 1

Downloads: (external link)
https://dipot.ulb.ac.be/dspace/bitstream/2013/283472/1/doi_267099.pdf Full text for the whole work, or for a work part (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:ulb:ulbeco:2013/283472

Ordering information: This working paper can be ordered from
http://hdl.handle.ne ... lb.ac.be:2013/283472

Access Statistics for this paper

More papers in ULB Institutional Repository from ULB -- Universite Libre de Bruxelles Contact information at EDIRC.
Bibliographic data for series maintained by Benoit Pauwels ().