Linear Correlation Between Mean Arterial Pressure and Urine Output in Critically Ill Patients

被引：0

作者：

Lichter, Yael ^{[1
,2
,3
]}

Oz, Amir Gal ^{[1
,3
]}

Adi, Nimrod ^{[1
,3
]}

Nini, Asaph ^{[1
,3
]}

Angel, Yoel ^{[1
,3
]}

Nevo, Andrey ^{[1
,3
]}

Aviram, Daniel ^{[1
,2
,3
]}

Moshkovits, Itay ^{[1
,3
]}

Wald, Ron ^{[4
,5
,6
]}

Stavi, Dekel ^{[1
,3
]}

Goder, Noam ^{[1
,3
,7
]}

机构：

[1] Tel Aviv Sourasky Med Ctr, Div Anesthesia Pain Management & Intens Care, Tel Aviv, Israel

[2] Univ Coll London Hosp NHS Fdn Trust, Crit Care Dept, London, England

[3] Tel Aviv Univ, Fac Med & Hlth Sci, Tel Aviv, Israel

[4] St Michaels Hosp, Div Nephrol, Toronto, ON, Canada

[5] Univ Toronto, Toronto, ON, Canada

[6] St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada

[7] Tel Aviv Sourasky Med Ctr, Div Surg, Tel Aviv, Israel

来源：

CRITICAL CARE EXPLORATIONS | 2024年 / 6卷 / 08期

关键词：

fluid balance; kidney; mean arterial pressure; urine output; ACUTE KIDNEY INJURY; RENAL BLOOD-FLOW; SEPTIC SHOCK; SEPSIS; NOREPINEPHRINE; AUTOREGULATION; MANAGEMENT; MECHANISMS; MORTALITY; OLIGURIA;

D O I：

暂无

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

OBJECTIVE: Mean arterial pressure (MAP) plays a significant role in regulating tissue perfusion and urine output (UO). The optimal MAP target in critically ill patients remains a subject of debate. We aimed to explore the relationship between MAP and UO. DESIGN: A retrospective observational study. SETTING: A general ICU in a tertiary medical center. PATIENTS: All critically ill patients admitted to the ICU for more than 10 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: MAP values and hourly UO were collected in 5,207 patients. MAP levels were categorized into 10 groups of 5 mm Hg (from MAP < 60 mm Hg to MAP > 100 mg Hg), and 656,423 coupled hourly mean MAP and UO measurements were analyzed. Additionally, we compared the UO of individual patients in each MAP group with or without norepinephrine (NE) support or diuretics, as well as in patients with acute kidney injury (AKI). Hourly UO rose incrementally between MAP values of 65-100 mm Hg. Among 2,226 patients treated with NE infusion, mean UO was significantly lower in the MAP less than 60 mm Hg group (53.4 mL/hr; 95% CI, 49.3-57.5) compared with all other groups (p < 0.001), but no differences were found between groups of 75 less than or equal to MAP. Among 2500 patients with AKI, there was a linear increase in average UO from the MAP less than 60 mm Hg group (57.1 mL/hr; 95% CI, 54.2-60.0) to the group with MAP greater than or equal to 100 mm Hg (89.4 mL/hr; 95% CI, 85.7-93.1). When MAP was greater than or equal to 65 mm Hg, we observed a statistically significant trend of increased UO in periods without NE infusion. CONCLUSIONS: Our analysis revealed a linear correlation between MAP and UO within the range of 65-100 mm Hg, also observed in the subgroup of patients treated with NE or diuretics and in those with AKI. These findings highlight the importance of tissue perfusion to the maintenance of diuresis and achieving adequate fluid balance in critically ill patients.

引用

页数：11

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[31] Oliguria without serum creatinine increase after living donor liver transplantation is associated with adverse post-operative outcomes [J].