Open Collections

UBC Faculty Research and Publications

Mean arterial pressure and mortality in patients with distributive shock: a retrospective analysis of the MIMIC-III database Vincent, Jean-Louis; Nielsen, Nathan D; Shapiro, Nathan I; Gerbasi, Margaret E; Grossman, Aaron; Doroff, Robin; Zeng, Feng; Young, Paul J; Russell, James A

Abstract

Background: Maintenance of mean arterial pressure (MAP) at levels sufficient to avoid tissue hypoperfusion is a key tenet in the management of distributive shock. We hypothesized that patients with distributive shock sometimes have a MAP below that typically recommended and that such hypotension is associated with increased mortality. Methods: In this retrospective analysis of the Medical Information Mart for Intensive Care (MIMIC-III) database from Beth Israel Deaconess Medical Center, Boston, USA, we included all intensive care unit (ICU) admissions between 2001 and 2012 with distributive shock, defined as continuous vasopressor support for ≥ 6 h and no evidence of low cardiac output shock. Hypotension was evaluated using five MAP thresholds: 80, 75, 65, 60 and 55 mmHg. We evaluated the longest continuous episode below each threshold during vasopressor therapy. The primary outcome was ICU mortality. Results: Of 5347 patients with distributive shock, 95.7%, 91.0%, 62.0%, 36.0% and 17.2%, respectively, had MAP 

Item Metadata

Title
Mean arterial pressure and mortality in patients with distributive shock: a retrospective analysis of the MIMIC-III database
Creator
Vincent, Jean-Louis; Nielsen, Nathan D; Shapiro, Nathan I; Gerbasi, Margaret E; Grossman, Aaron; Doroff, Robin; Zeng, Feng; Young, Paul J; Russell, James A
Contributor
St. Paul's Hospital (Vancouver, B.C.)
Publisher
Springer International Publishing
Date Issued
2018-11-08
Description
Background: Maintenance of mean arterial pressure (MAP) at levels sufficient to avoid tissue hypoperfusion is a key tenet in the management of distributive shock. We hypothesized that patients with distributive shock sometimes have a MAP below that typically recommended and that such hypotension is associated with increased mortality. Methods: In this retrospective analysis of the Medical Information Mart for Intensive Care (MIMIC-III) database from Beth Israel Deaconess Medical Center, Boston, USA, we included all intensive care unit (ICU) admissions between 2001 and 2012 with distributive shock, defined as continuous vasopressor support for ≥ 6 h and no evidence of low cardiac output shock. Hypotension was evaluated using five MAP thresholds: 80, 75, 65, 60 and 55 mmHg. We evaluated the longest continuous episode below each threshold during vasopressor therapy. The primary outcome was ICU mortality. Results: Of 5347 patients with distributive shock, 95.7%, 91.0%, 62.0%, 36.0% and 17.2%, respectively, had MAP 
Subject
Mean arterial pressure; Acute circulatory failure; Multiple organ failure; ICU mortality
Genre
Article
Type
Text
Language
eng
Date Available
2018-11-08
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0373609
URI
http://hdl.handle.net/2429/67779
Affiliation
Medicine, Faculty of; Other UBC; Non UBC; Medicine, Department of
Citation
Annals of Intensive Care. 2018 Nov 08;8(1):107
Publisher DOI
10.1186/s13613-018-0448-9
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

Item Media

Item Citations and Data

Rights

Attribution 4.0 International (CC BY 4.0)