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优化慢性高血压脓毒症休克患者的平均动脉压目标:一项叙述性综述

Optimizing Mean Arterial Pressure Targets for Septic Shock Patients With Chronic Hypertension: A Narrative Review.

作者信息

Othman Mutaz I, Mustafa Emad M, Abdelwahab Ahmed E, Hssain Ali A, Nashwan Abdulqadir J

机构信息

Nursing Department Hamad Medical Corporation Doha Qatar.

Department of Critical Care Hamad Medical Corporation Doha Qatar.

出版信息

Health Sci Rep. 2025 May 19;8(5):e70696. doi: 10.1002/hsr2.70696. eCollection 2025 May.

Abstract

BACKGROUND AND AIMS

Septic shock is a serious infection-related condition that has a big effect on public health. To improve organ perfusion and prognosis in septic shock patients with chronic high blood pressure, optimal mean arterial pressure (MAP) targets are needed. This narrative review aims to summarize existing knowledge and factors to determine the most effective MAP targets in septic shock patients with chronic hypertension.

METHODS

A careful review of relevant literature was conducted to understand the factors that affect MAP targets in septic shock patients with chronic hypertension. Long-term hypertension patients require personalized MAP targets based on age, health conditions, and septic shock severity.

RESULTS

five studies were identified in this narrative review. Guidelines suggest 65-75 mmHg for most cases, but higher targets may be beneficial for proper organ perfusion. Continuous hemodynamic monitoring allows dynamic adjustment of MAP targets.

CONCLUSION

It is crucial to implement personalized MAP management strategies to achieve optimal outcomes for patients with chronic hypertension who are experiencing septic shock. However, there is a lack of consensus on optimal MAP targets among patients with chronic hypertension, which may require higher MAP targets to maintain adequate tissue perfusion. An approach that considers each patient's unique characteristics and includes ongoing assessment is critical for achieving the best MAP targets and improving patient prognosis.

摘要

背景与目的

感染性休克是一种严重的感染相关病症,对公众健康有重大影响。为改善慢性高血压感染性休克患者的器官灌注和预后,需要最佳平均动脉压(MAP)目标。本叙述性综述旨在总结现有知识和因素,以确定慢性高血压感染性休克患者最有效的MAP目标。

方法

对相关文献进行仔细回顾,以了解影响慢性高血压感染性休克患者MAP目标的因素。长期高血压患者需要根据年龄、健康状况和感染性休克严重程度制定个性化的MAP目标。

结果

本叙述性综述纳入了五项研究。指南建议大多数情况下为65 - 75 mmHg,但更高的目标可能有利于适当的器官灌注。持续的血流动力学监测可动态调整MAP目标。

结论

实施个性化的MAP管理策略对于慢性高血压合并感染性休克患者实现最佳治疗效果至关重要。然而,慢性高血压患者对于最佳MAP目标缺乏共识,可能需要更高的MAP目标来维持足够的组织灌注。考虑每个患者独特特征并进行持续评估的方法对于实现最佳MAP目标和改善患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d507/12086642/fbd298020c37/HSR2-8-e70696-g001.jpg

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