Mean arterial pressure targets in intensive care unit patients receiving noradrenaline: An international survey.

OBJECTIVE

This study aimed to evaluate intensive care doctors' views about a large-scale pragmatic minimum mean arterial pressure (MAP) targets trial and their attitudes and beliefs about minimum MAP targets in different clinical scenarios.

DESIGN

An online survey was conducted.

SETTING AND PARTICIPANTS

An online survey was distributed to intensive care doctors in sites participating in a large-scale international randomised clinical trial evaluating oxygen therapy targets in 15 countries and to additional intensive care clinicians from Canada.

MAIN OUTCOME MEASURES

Outcomes included the expressed level of support for a large pragmatic trial to evaluate minimum MAP targets in critically ill adults and stated current practice and acceptability of minimum MAP for specific scenarios.

RESULTS

The response rate to our survey for respondents who work in sites participating in the mega randomised registry trial research program was 265 out of 701 (37.8%), with an additional 56 out of 256 (21.8%) responses obtained from a direct email containing a link to the survey sent to intensive care clinicians in Canada. A total of 309 of 321 respondents (96.3%) were supportive, in principle, of conducting a very large pragmatic trial to evaluate MAP targets in intensive care unit patients receiving noradrenaline. The commonest response in all scenarios was to agree that the optimal minimum MAP target was uncertain. In all scenarios, except for active bleeding, the most common reported minimum MAP target was 65 mmHg; for patients who were actively bleeding, the most common reported target was 60 mmHg.

CONCLUSIONS

Our data suggest that intensive care clinicians are broadly supportive of a large-scale pragmatic minimum MAP targets in intensive care unit patients receiving noradrenaline.