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Does the Mean Arterial Pressure Influence Mortality Rate in Patients with Acute Hypoxemic Respiratory Failure under Mechanical Ventilation?

Gjonbrataj J, Kim HJ, Jung HI, Choi WI - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended.At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different.The ICU days, hospital days, and 60-day mortality rate did not differ between the groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. ; Department of Internal Medicine, Mother Thereza University Hospital, Tirana, Albania.

ABSTRACT

Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation.

Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU.

Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups.

Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.

No MeSH data available.


Related in: MedlinePlus

Flow chart of patients who sustained mean arterial pressure (MAP) of 65 to 90 mm Hg over the first 24 hours of the intensive care unit (ICU) admission among hypoxemic respiratory failure.
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Figure 1: Flow chart of patients who sustained mean arterial pressure (MAP) of 65 to 90 mm Hg over the first 24 hours of the intensive care unit (ICU) admission among hypoxemic respiratory failure.

Mentions: Of the 844 patients diagnosed with AHRF, 338 individuals fulfilled the required criteria for our study (Figure 1). The population demographics for patients with low MAP over the first 24 hours as compared to the patients with high MAP over the first 24 hours is summarized in Table 1. The mean patient age in both groups was 60 years, and 65% of all patients were men. Sepsis was the most probable cause of AHRF in 26% of patients, while cancer and diabetes were the most common co-morbidities, affecting 89 (26%) and 79 (23%) patients, respectively. Chronic obstructive pulmonary disease as a co-morbidity occurred in a significantly higher number of patients with high MAP than in patients with low MAP. Meanwhile sepsis affected higher percentage of patients with low MAP than those with high MAP. The high MAP group had a significantly higher PaO2/FIO2 ratio and C-reactive protein than the low MAP group. ARDS was present in 20% of the patients with low MAP, and in 22.4% of the patients with high MAP. The duration of ICU stay, hospital stay, and 60-day mortality rate did not differ between the two groups.


Does the Mean Arterial Pressure Influence Mortality Rate in Patients with Acute Hypoxemic Respiratory Failure under Mechanical Ventilation?

Gjonbrataj J, Kim HJ, Jung HI, Choi WI - Tuberc Respir Dis (Seoul) (2015)

Flow chart of patients who sustained mean arterial pressure (MAP) of 65 to 90 mm Hg over the first 24 hours of the intensive care unit (ICU) admission among hypoxemic respiratory failure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388905&req=5

Figure 1: Flow chart of patients who sustained mean arterial pressure (MAP) of 65 to 90 mm Hg over the first 24 hours of the intensive care unit (ICU) admission among hypoxemic respiratory failure.
Mentions: Of the 844 patients diagnosed with AHRF, 338 individuals fulfilled the required criteria for our study (Figure 1). The population demographics for patients with low MAP over the first 24 hours as compared to the patients with high MAP over the first 24 hours is summarized in Table 1. The mean patient age in both groups was 60 years, and 65% of all patients were men. Sepsis was the most probable cause of AHRF in 26% of patients, while cancer and diabetes were the most common co-morbidities, affecting 89 (26%) and 79 (23%) patients, respectively. Chronic obstructive pulmonary disease as a co-morbidity occurred in a significantly higher number of patients with high MAP than in patients with low MAP. Meanwhile sepsis affected higher percentage of patients with low MAP than those with high MAP. The high MAP group had a significantly higher PaO2/FIO2 ratio and C-reactive protein than the low MAP group. ARDS was present in 20% of the patients with low MAP, and in 22.4% of the patients with high MAP. The duration of ICU stay, hospital stay, and 60-day mortality rate did not differ between the two groups.

Bottom Line: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended.At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different.The ICU days, hospital days, and 60-day mortality rate did not differ between the groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. ; Department of Internal Medicine, Mother Thereza University Hospital, Tirana, Albania.

ABSTRACT

Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation.

Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU.

Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups.

Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.

No MeSH data available.


Related in: MedlinePlus