Should we target blood pressure in XXXX ?

@entity1 @entity551 @entity295
OBJECTIVE: To review blood pressure targets and their implementation in @entity295 . DESIGN: Review of the hemodynamic intervention trials in @entity295 . MAIN RESULTS AND CONCLUSIONS: Explicit blood pressure targets have been recommended for septic @entity1 . The Surviving Sepsis Guidelines recommend vasopressors to achieve and maintain a mean arterial blood pressure of at least 65 mm Hg in @entity1 not responding to initial fluid resuscitation. @entity1 remaining @entity551 despite efforts to increase blood pressure have up to twice as high mortality as those whose @entity551 can be corrected with fluids and vasopressors. The actual blood pressure targets and their implementation are the main determinants of the @entity1 's exposure to vasopressors. Several randomized controlled trials on hemodynamic interventions in septic shock show that @entity1 continue to receive vasopressors despite the fact that blood pressure targets have been exceeded, and thus vasopressors should be reduced. Accordingly, @entity1 are likely to be exposed to higher amounts of vasopressors and over longer periods of time than would be necessary if the predefined targets would be strictly implemented. Post hoc analyses suggest that in @entity1 without refractory @entity551 , the cumulative vasopressor load is independently associated with mortality. Accordingly, reduction of exposure to vasopressors has the potential of improving outcomes. This can be achieved by adhering to the lower currently proposed blood pressure limits. In addition, the lowest tolerable blood pressure levels should be reevaluated.
