Intensive Care Network Podcasts

Blood Pressure (BP) is one of the vital hemodynamic parameters that we often aim to optimize for critically ill patients. Our decisions regarding BP targets, and ensuing use (or avoidance) of vasopressor agents, may directly impact on outcomes for these patients. Despite being a fundamental tenet of critical care, there is a lack of quality evidence to suggest optimal BP targets or to guide the use of vasopressors for individual patients with shock. A mean arterial BP (MAP) of 65-70 mmHg is an often-cited initial BP target for patients during vasopressor therapy. Use of vasopressors to maintain MAP of 65 mmHg or greater remains one of the core clinical criteria in the new definition of septic shock. However, such standard targets are unlikely to be applicable to all patients, many of whom would have a basal MAP higher than 65-70 mmHg, often to a varying degree, during their usual pre-illness state. Therefore, a vasopressor therapy guided by standard BP thresholds may result in a variable degree of untreated r