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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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lunes, 25 de mayo de 2020

Mean Arterial Pressure in Sepsis

PulmCCM
PulmCCM - May 24, 2020 - By Jon-Emile S. Kenny
"What They Did
The 65 Trial was a pragmatic, multi-centre, randomised controlled trial. Patients over the age of 65 were recruited from 65 National Health Service [NHS] adult, general, critical care units. They were with vasodilatory hypotension and having had received vasopressors for at least one hour.
Those randomized to the intervention group received ‘permissive hypotension’ [i.e. mean arterial pressure target range of 60 – 65 mmHg on vasopressors]. Those in the control group received usual care; many different vasoactives were employed.
The primary outcome was 90-day mortality while secondary outcomes were: mortality at hospital discharge, duration of survival to longest available follow-up, duration of advanced respiratory and renal support, days alive and free of advanced respiratory support and renal support, duration of critical care unit and acute hospital stay. They also assessed long-term cognitive function.
What They Found
2600 patients were randomized and 2463 were in the final analysis; the patients were similar at baseline. Mortality in the permissive hypotension group was 41% while it was 43.8 % in the control group; this was not statistically significant. With respect to secondary outcomes, there was a reduction in total vasopressor dose, and no difference in duration of mechanical ventilation or cognitive function..."