Comparison of High-Normal Versus Low-Normal Mean Arterial Pressure at Target on Outcomes in Sepsis or Shock Patients: A Meta-Analysis of Randomized Control Trials

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Feb 14

PMID 38352092

Authors

Mohammedsefa A Dari

Azrung Fayaz

Shazia Sharif

Servando Hernandez Galaviz

Eruviel Hernandez Galaviz

Sohaib M Bataineh

Calvin R Wei

Danish Allahwala

Affiliations

Soon will be listed here.

Abstract

The objective of this meta-analysis was to compare the impact of a high-normal and a low-normal mean arterial pressure (MAP) target on outcomes in patients with sepsis or shock. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, two investigators conducted a thorough literature search across online databases, including PubMed, Cochrane Library, Web of Science, and EMBASE, spanning from inception to December 10, 2023. The assessed outcomes encompassed all-cause mortality, the need for renal replacement therapy, and the length of intensive care unit (ICU) stay. A total of four randomized controlled trials (RCTs) were included, involving 3507 participants with individual study participant counts ranging from 118 to 2463. The pooled analysis revealed no statistically significant difference in the risk of all-cause mortality between the two groups (Risk Ratio (RR): 0.94, 95% Confidence Interval (CI): 0.87 to 1.01). Furthermore, there was no disparity in the rates of renal replacement therapy and the duration of ICU stay between the high-normal and low-normal MAP groups. Our findings indicate no significant distinctions in mortality, rates of renal replacement therapy, or ICU stay duration between the two groups. However, future trials with larger sample sizes are warranted to comprehensively understand the nuanced effects of different MAP settings on outcomes in patients with sepsis and shock.

Citing Articles

Optimal target mean arterial pressure for patients with sepsis-associated encephalopathy: a retrospective cohort study.

Peng H, Liang Z, Zhang S, Yang Y BMC Infect Dis. 2024; 24(1):902.

PMID: 39223467 PMC: 11367872. DOI: 10.1186/s12879-024-09789-w.

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