Skip to main content
Erschienen in: Intensive Care Medicine 9/2019

05.08.2019 | Editorial

Focus on blood pressure targets and vasopressors in critically ill patients

verfasst von: Anders Perner, Peter B. Hjortrup, Yaseen Arabi

Erschienen in: Intensive Care Medicine | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

Excerpt

For patients in shock, decisions on blood pressure targets are an ongoing task for the clinicians at the bedside in critical care settings. In general, there are only limited amount of data from studies with lower risk of bias to support the clinicians in these decisions. However, in recent years, large cohort studies and randomised clinical trials (RCTs) have given us somewhat better data to support better care. …
Literatur
1.
Zurück zum Zitat Maheshwari K, Nathanson BH, Munson SH, Khangulov V, Stevens M, Badani H, Khanna AK, Sessler DI (2018) The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med 44:857–867CrossRefPubMedPubMedCentral Maheshwari K, Nathanson BH, Munson SH, Khangulov V, Stevens M, Badani H, Khanna AK, Sessler DI (2018) The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med 44:857–867CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Sessler DI, Khanna AK (2018) Perioperative myocardial injury and the contribution of hypotension. Intensive Care Med 44:811–822CrossRefPubMed Sessler DI, Khanna AK (2018) Perioperative myocardial injury and the contribution of hypotension. Intensive Care Med 44:811–822CrossRefPubMed
3.
Zurück zum Zitat Asfar P, Radermacher P, Ostermann M (2018) MAP of 65: target of the past? Intensive Care Med 44:1551–1552CrossRefPubMed Asfar P, Radermacher P, Ostermann M (2018) MAP of 65: target of the past? Intensive Care Med 44:1551–1552CrossRefPubMed
4.
Zurück zum Zitat Perner A, Bellomo R, Moller MH (2019) Is research from databases reliable? No. Intensive Care Med 45:115–117CrossRefPubMed Perner A, Bellomo R, Moller MH (2019) Is research from databases reliable? No. Intensive Care Med 45:115–117CrossRefPubMed
5.
Zurück zum Zitat Lavillegrand JR, Dumas G, Bige N, Zafimahazo D, Guidet B, Maury E, Ait-Oufella H (2018) Should we treat mild hypotension in septic patients in the absence of peripheral tissue hypoperfusion? Intensive Care Med 44:1593–1594CrossRefPubMed Lavillegrand JR, Dumas G, Bige N, Zafimahazo D, Guidet B, Maury E, Ait-Oufella H (2018) Should we treat mild hypotension in septic patients in the absence of peripheral tissue hypoperfusion? Intensive Care Med 44:1593–1594CrossRefPubMed
6.
Zurück zum Zitat Hernandez G, Ospina-Tascon GA, Damiani LP, Estenssoro E, Dubin A, Hurtado J, Friedman G, Castro R, Alegria L, Teboul JL, Cecconi M, Ferri G, Jibaja M, Pairumani R, Fernandez P, Barahona D, Granda-Luna V, Cavalcanti AB, Bakker J, The ASI, the Latin America Intensive Care N, Hernandez G, Ospina-Tascon G, Petri Damiani L, Estenssoro E, Dubin A, Hurtado J, Friedman G, Castro R, Alegria L, Teboul JL, Cecconi M, Cecconi M, Ferri G, Jibaja M, Pairumani R, Fernandez P, Barahona D, Cavalcanti AB, Bakker J, Hernandez G, Alegria L, Ferri G, Rodriguez N, Holger P, Soto N, Pozo M, Bakker J, Cook D, Vincent JL, Rhodes A, Kavanagh BP, Dellinger P, Rietdijk W, Carpio D, Pavez N, Henriquez E, Bravo S, Valenzuela ED, Vera M, Dreyse J, Oviedo V, Cid MA, Larroulet M, Petruska E, Sarabia C, Gallardo D, Sanchez JE, Gonzalez H, Arancibia JM, Munoz A, Ramirez G, Aravena F, Aquevedo A, Zambrano F, Bozinovic M, Valle F, Ramirez M, Rossel V, Munoz P, Ceballos C, Esveile C, Carmona C, Candia E, Mendoza D, Sanchez A, Ponce D, Ponce D, Lastra J, Nahuelpan B, Fasce F, Luengo C, Medel N, Cortes C, Campassi L, Rubatto P, Horna N, Furche M, Pendino JC, Bettini L, Lovesio C, Gonzalez MC, Rodruguez J, Canales H, Caminos F, Galletti C, Minoldo E, Aramburu MJ, Olmos D, Nin N, Tenzi J, Quiroga C, Lacuesta P, Gaudin A, Pais R, Silvestre A, Olivera G, Rieppi G, Berrutti D, Ochoa M, Cobos P, Vintimilla F, Ramirez V, Tobar M, Garcia F, Picoita F, Remache N, Granda V, Paredes F, Barzallo E, Garces P, Guerrero F, Salazar S, Torres G, Tana C, Calahorrano J, Solis F, Torres P, Herrera L, Ornes A, Perez V, Delgado G, Lopez A, Espinosa E, Moreira J, Salcedo B, Villacres I, Suing J, Lopez M, Gomez L, Toctaquiza G, Cadena Zapata M, Orazabal MA, Pardo Espejo R, Jimenez J, Calderon A, Paredes G, Barberan JL, Moya T, Atehortua H, Sabogal R, Ortiz G, Lara A, Sanchez F, Hernan Portilla A, Davila H, Mora JA, Calderon LE, Alvarez I, Escobar E, Bejarano A, Bustamante LA, Aldana JL (2019) Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK randomized clinical trial. JAMA 321:654–664CrossRefPubMedPubMedCentral Hernandez G, Ospina-Tascon GA, Damiani LP, Estenssoro E, Dubin A, Hurtado J, Friedman G, Castro R, Alegria L, Teboul JL, Cecconi M, Ferri G, Jibaja M, Pairumani R, Fernandez P, Barahona D, Granda-Luna V, Cavalcanti AB, Bakker J, The ASI, the Latin America Intensive Care N, Hernandez G, Ospina-Tascon G, Petri Damiani L, Estenssoro E, Dubin A, Hurtado J, Friedman G, Castro R, Alegria L, Teboul JL, Cecconi M, Cecconi M, Ferri G, Jibaja M, Pairumani R, Fernandez P, Barahona D, Cavalcanti AB, Bakker J, Hernandez G, Alegria L, Ferri G, Rodriguez N, Holger P, Soto N, Pozo M, Bakker J, Cook D, Vincent JL, Rhodes A, Kavanagh BP, Dellinger P, Rietdijk W, Carpio D, Pavez N, Henriquez E, Bravo S, Valenzuela ED, Vera M, Dreyse J, Oviedo V, Cid MA, Larroulet M, Petruska E, Sarabia C, Gallardo D, Sanchez JE, Gonzalez H, Arancibia JM, Munoz A, Ramirez G, Aravena F, Aquevedo A, Zambrano F, Bozinovic M, Valle F, Ramirez M, Rossel V, Munoz P, Ceballos C, Esveile C, Carmona C, Candia E, Mendoza D, Sanchez A, Ponce D, Ponce D, Lastra J, Nahuelpan B, Fasce F, Luengo C, Medel N, Cortes C, Campassi L, Rubatto P, Horna N, Furche M, Pendino JC, Bettini L, Lovesio C, Gonzalez MC, Rodruguez J, Canales H, Caminos F, Galletti C, Minoldo E, Aramburu MJ, Olmos D, Nin N, Tenzi J, Quiroga C, Lacuesta P, Gaudin A, Pais R, Silvestre A, Olivera G, Rieppi G, Berrutti D, Ochoa M, Cobos P, Vintimilla F, Ramirez V, Tobar M, Garcia F, Picoita F, Remache N, Granda V, Paredes F, Barzallo E, Garces P, Guerrero F, Salazar S, Torres G, Tana C, Calahorrano J, Solis F, Torres P, Herrera L, Ornes A, Perez V, Delgado G, Lopez A, Espinosa E, Moreira J, Salcedo B, Villacres I, Suing J, Lopez M, Gomez L, Toctaquiza G, Cadena Zapata M, Orazabal MA, Pardo Espejo R, Jimenez J, Calderon A, Paredes G, Barberan JL, Moya T, Atehortua H, Sabogal R, Ortiz G, Lara A, Sanchez F, Hernan Portilla A, Davila H, Mora JA, Calderon LE, Alvarez I, Escobar E, Bejarano A, Bustamante LA, Aldana JL (2019) Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK randomized clinical trial. JAMA 321:654–664CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Asfar P, Meziani F, Hamel JF, Grelon F, Megarbane B, Anguel N, Mira JP, Dequin PF, Gergaud S, Weiss N, Legay F, Le TY, Conrad M, Robert R, Gonzalez F, Guitton C, Tamion F, Tonnelier JM, Guezennec P, Van Der Linden T, Vieillard-Baron A, Mariotte E, Pradel G, Lesieur O, Ricard JD, Herve F, Du CD, Guerin C, Mercat A, Teboul JL, Radermacher P (2014) High versus low blood-pressure target in patients with septic shock. N Engl J Med 370:1583–1593CrossRefPubMed Asfar P, Meziani F, Hamel JF, Grelon F, Megarbane B, Anguel N, Mira JP, Dequin PF, Gergaud S, Weiss N, Legay F, Le TY, Conrad M, Robert R, Gonzalez F, Guitton C, Tamion F, Tonnelier JM, Guezennec P, Van Der Linden T, Vieillard-Baron A, Mariotte E, Pradel G, Lesieur O, Ricard JD, Herve F, Du CD, Guerin C, Mercat A, Teboul JL, Radermacher P (2014) High versus low blood-pressure target in patients with septic shock. N Engl J Med 370:1583–1593CrossRefPubMed
8.
Zurück zum Zitat Lamontagne F, Meade MO, Hebert PC, Asfar P, Lauzier F, Seely AJE, Day AG, Mehta S, Muscedere J, Bagshaw SM, Ferguson ND, Cook DJ, Kanji S, Turgeon AF, Herridge MS, Subramanian S, Lacroix J, Adhikari NKJ, Scales DC, Fox-Robichaud A, Skrobik Y, Whitlock RP, Green RS, Koo KKY, Tanguay T, Magder S, Heyland DK (2016) Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med 42:542–550CrossRefPubMed Lamontagne F, Meade MO, Hebert PC, Asfar P, Lauzier F, Seely AJE, Day AG, Mehta S, Muscedere J, Bagshaw SM, Ferguson ND, Cook DJ, Kanji S, Turgeon AF, Herridge MS, Subramanian S, Lacroix J, Adhikari NKJ, Scales DC, Fox-Robichaud A, Skrobik Y, Whitlock RP, Green RS, Koo KKY, Tanguay T, Magder S, Heyland DK (2016) Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med 42:542–550CrossRefPubMed
9.
Zurück zum Zitat Lamontagne F, Day AG, Meade MO, Cook DJ, Guyatt GH, Hylands M, Radermacher P, Chretien JM, Beaudoin N, Hebert P, D’Aragon F, Meziani F, Asfar P (2018) Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock. Intensive Care Med 44:12–21CrossRefPubMed Lamontagne F, Day AG, Meade MO, Cook DJ, Guyatt GH, Hylands M, Radermacher P, Chretien JM, Beaudoin N, Hebert P, D’Aragon F, Meziani F, Asfar P (2018) Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock. Intensive Care Med 44:12–21CrossRefPubMed
10.
Zurück zum Zitat Lamontagne F, Marshall JC, Adhikari NKJ (2018) Permissive hypotension during shock resuscitation: equipoise in all patients? Intensive Care Med 44:87–90CrossRefPubMed Lamontagne F, Marshall JC, Adhikari NKJ (2018) Permissive hypotension during shock resuscitation: equipoise in all patients? Intensive Care Med 44:87–90CrossRefPubMed
11.
Zurück zum Zitat Liu ZM, Chen J, Kou Q, Lin Q, Huang X, Tang Z, Kang Y, Li K, Zhou L, Song Q, Sun T, Zhao L, Wang X, He X, Wang C, Wu B, Lin J, Yuan S, Gu Q, Qian K, Shi X, Feng Y, Lin A, He X, Study Group of I, Guan XD (2018) Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial. Intensive Care Med 44:1816–1825CrossRefPubMed Liu ZM, Chen J, Kou Q, Lin Q, Huang X, Tang Z, Kang Y, Li K, Zhou L, Song Q, Sun T, Zhao L, Wang X, He X, Wang C, Wu B, Lin J, Yuan S, Gu Q, Qian K, Shi X, Feng Y, Lin A, He X, Study Group of I, Guan XD (2018) Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial. Intensive Care Med 44:1816–1825CrossRefPubMed
12.
Zurück zum Zitat Martensson J, Gordon AC (2018) Terlipressin or norepinephrine, or both in septic shock? Intensive Care Med 44:1964–1966CrossRefPubMed Martensson J, Gordon AC (2018) Terlipressin or norepinephrine, or both in septic shock? Intensive Care Med 44:1964–1966CrossRefPubMed
13.
Zurück zum Zitat Moller MH, Claudius C, Junttila E, Haney M, Oscarsson-Tibblin A, Haavind A, Perner A (2016) Scandinavian SSAI clinical practice guideline on choice of first-line vasopressor for patients with acute circulatory failure. Acta Anaesthesiol Scand 60:1347–1366CrossRefPubMedPubMedCentral Moller MH, Claudius C, Junttila E, Haney M, Oscarsson-Tibblin A, Haavind A, Perner A (2016) Scandinavian SSAI clinical practice guideline on choice of first-line vasopressor for patients with acute circulatory failure. Acta Anaesthesiol Scand 60:1347–1366CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Nagendran M, Russell JA, Walley KR, Brett SJ, Perkins GD, Hajjar L, Mason AJ, Ashby D, Gordon AC (2019) Vasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials. Intensive Care Med 45:844–855CrossRefPubMed Nagendran M, Russell JA, Walley KR, Brett SJ, Perkins GD, Hajjar L, Mason AJ, Ashby D, Gordon AC (2019) Vasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials. Intensive Care Med 45:844–855CrossRefPubMed
15.
Zurück zum Zitat Lewis RJ, Angus DC, Laterre PF, Kjolbye AL, van der Meulen E, Blemings A, Graves T, Russell JA, Carlsen JE, Jacobsen K, Yealy DM, Opal SM, Windelov NA, Francois B, Perner A, Pickkers P, Berry SM (2018) Rationale and design of an adaptive phase 2b/3 clinical trial of selepressin for adults in septic shock. Selepressin evaluation programme for sepsis-induced shock-adaptive clinical trial. Ann Am Thorac Soc 15:250–257CrossRefPubMed Lewis RJ, Angus DC, Laterre PF, Kjolbye AL, van der Meulen E, Blemings A, Graves T, Russell JA, Carlsen JE, Jacobsen K, Yealy DM, Opal SM, Windelov NA, Francois B, Perner A, Pickkers P, Berry SM (2018) Rationale and design of an adaptive phase 2b/3 clinical trial of selepressin for adults in septic shock. Selepressin evaluation programme for sepsis-induced shock-adaptive clinical trial. Ann Am Thorac Soc 15:250–257CrossRefPubMed
16.
Zurück zum Zitat Khanna A, English SW, Wang XS, Ham K, Tumlin J, Szerlip H, Busse LW, Altaweel L, Albertson TE, Mackey C, McCurdy MT, Boldt DW, Chock S, Young PJ, Krell K, Wunderink RG, Ostermann M, Murugan R, Gong MN, Panwar R, Hastbacka J, Favory R, Venkatesh B, Thompson BT, Bellomo R, Jensen J, Kroll S, Chawla LS, Tidmarsh GF, Deane AM, Investigators A (2017) Angiotensin II for the treatment of vasodilatory shock. N Engl J Med 377:419–430CrossRefPubMed Khanna A, English SW, Wang XS, Ham K, Tumlin J, Szerlip H, Busse LW, Altaweel L, Albertson TE, Mackey C, McCurdy MT, Boldt DW, Chock S, Young PJ, Krell K, Wunderink RG, Ostermann M, Murugan R, Gong MN, Panwar R, Hastbacka J, Favory R, Venkatesh B, Thompson BT, Bellomo R, Jensen J, Kroll S, Chawla LS, Tidmarsh GF, Deane AM, Investigators A (2017) Angiotensin II for the treatment of vasodilatory shock. N Engl J Med 377:419–430CrossRefPubMed
17.
Zurück zum Zitat Teboul JL, Duranteau J, Russell JA (2018) Intensive care medicine in 2050: vasopressors in sepsis. Intensive Care Med 44:1130–1132CrossRefPubMed Teboul JL, Duranteau J, Russell JA (2018) Intensive care medicine in 2050: vasopressors in sepsis. Intensive Care Med 44:1130–1132CrossRefPubMed
18.
Zurück zum Zitat Whitson MR, Mo E, Nabi T, Healy L, Koenig S, Narasimhan M, Mayo PH (2016) Feasibility, utility, and safety of midodrine during recovery phase from septic shock. Chest 149:1380–1383CrossRefPubMed Whitson MR, Mo E, Nabi T, Healy L, Koenig S, Narasimhan M, Mayo PH (2016) Feasibility, utility, and safety of midodrine during recovery phase from septic shock. Chest 149:1380–1383CrossRefPubMed
Metadaten
Titel
Focus on blood pressure targets and vasopressors in critically ill patients
verfasst von
Anders Perner
Peter B. Hjortrup
Yaseen Arabi
Publikationsdatum
05.08.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 9/2019
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05716-9

Weitere Artikel der Ausgabe 9/2019

Intensive Care Medicine 9/2019 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.