Is There a Good MAP for Septic Shock?
N Engl J Med. 2014 Mar 18;
Authors: Russell JA
As fundamental as the issue is, there is no clear, high-level evidence to determine the most effective mean arterial pressure (MAP) for resuscitation of patients with septic shock. During hypotension, three salient aspects of cardiovascular physiology are important. First, the autoregulation of cerebral blood flow maintains an adequate level over a wide range of pressures until a critical pressure (about 50 mm Hg) is reached; below this level, as the pressure falls, so does cerebral blood flow. Second, chronic hypertension shifts the autoregulatory curve of the relationship between pressure and perfusion so that perfusion is decreased at a higher critical . . .
PMID: 24635771 [PubMed - as supplied by publisher]