Tuberc Respir Dis.  2015 Apr;78(2):85-91. 10.4046/trd.2015.78.2.85.

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

• KMID: 2320599
• DOI: http://doi.org/10.4046/trd.2015.78.2.85

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.

Keyword

Arterial Pressure; Respiratory Insufficiency; Respiration, Artificial

MeSH Terms

Arterial Pressure*
Humans
Intensive Care Units
Mortality*
Prospective Studies
Respiration, Artificial*
Respiratory Insufficiency*
Sepsis

Figure

• 

  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.

• 

  Figure 2 Kaplan-Meier survival curves: patients with low mean arterial pressure (MAP) (65-74.9 mm Hg) (solid line) compared to patients with high MAP (75-89.9 mm Hg) (dotted line).

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