Mean arterial pressure targets in intensive care unit patients receiving noradrenaline: An international survey

IF 1.4 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation Pub Date : 2025-03-01 DOI:10.1016/j.ccrj.2024.12.001

Paul J. Young MBChB, PhD , Rinaldo Bellomo MBBS, MD, FCICM, FRACP , Abdulrahman Al-Fares MBChB, FRCPC, ABIM, MRCP , David GC. Antognini MBBS , Yaseen M. Arabi MD , Muhammad Sheharyar Ashraf MD , Sean M. Bagshaw MD, MSc , Alastair J. Brown MBChB , Sarah Buabbas MD , Lewis Campbell MBChB, MSc , Jonathan M. Chen MBChB , Ross C. Freebairn MBChB , Tomoko Fujii MD, PhD , Mohd Shahnaz Hasan MBBS, MAnes , Aditi Jain DNB, FRCPC, FCCCM, AFIC , Nai An Lai MBBS, MRCSEd, FRCP(Edin), FCICM , Sanjay Lakhey MD , Matthew Mac Partlin MBChB, FCICM, FACEM, MRCPI , Sam Marment MBChB , James P.A. McCullough MBChB, MMed , François Lamontagne MD, MSc

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引用次数: 0

Abstract

Objective

This study aimed to evaluate intensive care doctors’ views about a large-scale pragmatic minimum mean arterial pressure (MAP) targets trial and their attitudes and beliefs about minimum MAP targets in different clinical scenarios.

Design

An online survey was conducted.

Setting and participants

An online survey was distributed to intensive care doctors in sites participating in a large-scale international randomised clinical trial evaluating oxygen therapy targets in 15 countries and to additional intensive care clinicians from Canada.

Main outcome measures

Outcomes included the expressed level of support for a large pragmatic trial to evaluate minimum MAP targets in critically ill adults and stated current practice and acceptability of minimum MAP for specific scenarios.

Results

The response rate to our survey for respondents who work in sites participating in the mega randomised registry trial research program was 265 out of 701 (37.8%), with an additional 56 out of 256 (21.8%) responses obtained from a direct email containing a link to the survey sent to intensive care clinicians in Canada. A total of 309 of 321 respondents (96.3%) were supportive, in principle, of conducting a very large pragmatic trial to evaluate MAP targets in intensive care unit patients receiving noradrenaline. The commonest response in all scenarios was to agree that the optimal minimum MAP target was uncertain. In all scenarios, except for active bleeding, the most common reported minimum MAP target was 65 mmHg; for patients who were actively bleeding, the most common reported target was 60 mmHg.

Conclusions

Our data suggest that intensive care clinicians are broadly supportive of a large-scale pragmatic minimum MAP targets in intensive care unit patients receiving noradrenaline.

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接受去甲肾上腺素治疗的重症监护病房患者的平均动脉压目标：一项国际调查

目的探讨重症监护医生对大规模实用最低平均动脉压（MAP）靶标试验的看法及不同临床情景下对最低动脉压靶标的态度和信念。设计进行了一项在线调查。背景和参与者：一份在线调查被分发给参加15个国家的大型国际随机临床试验的重症监护医生，以及来自加拿大的其他重症监护医生。主要结局指标包括对一项大型实用试验的支持程度，该试验旨在评估危重成人的最低MAP目标，并陈述了目前的做法和特定情况下最低MAP的可接受性。结果我们对参与大型随机注册试验研究项目的受访者进行的调查的回复率为701人中有265人（37.8%），另外256人中有56人（21.8%）是通过直接发送给加拿大重症监护临床医生的包含调查链接的电子邮件获得的。321名应答者中有309人（96.3%）原则上支持开展一项非常大规模的实用试验，以评估接受去甲肾上腺素治疗的重症监护病房患者的MAP靶点。在所有场景中，最常见的反应是同意最佳最小MAP目标是不确定的。在所有情况下，除活动性出血外，最常见的最低MAP目标为65 mmHg；对于活动性出血患者，最常见的报告目标是60 mmHg。结论：我们的数据表明，重症监护临床医生广泛支持在接受去甲肾上腺素治疗的重症监护病房患者中大规模实用的最低MAP目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Care and Resuscitation CRITICAL CARE MEDICINE-

CiteScore

7.70

自引率

3.40%

发文量

审稿时长

>12 weeks

期刊介绍： ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.