Interactive journal of medical research
Impact of Elevated Blood Pressure Targets on Splanchnic Ischemia and Mortality in Septic Resuscitation: Systematic Review
By Cisneros P, Ortiz Caviedes JF, Piñeros Ladino LM and 4 others.
Abstract
Background
Sepsis causes deaths worldwide each day, with hemodynamic resuscitation being central to management. Guidelines recommend a 65-mm Hg mean arterial pressure (MAP) target, yet the evidence for elevated targets remains fragmented across mortality, renal, and splanchnic outcomes.
Objective
This review aims to comprehensively appraise the impact of elevated MAP targets on splanchnic ischemia, mortality, and organ-specific outcomes in septic resuscitation.
Methods
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, we systematically searched PubMed, the Cochrane Library, and Google Scholar for studies comparing MAP targets in septic shock. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2; randomized controlled trials [RCTs]) and the Newcastle-Ottawa Scale (nonrandomized studies). The findings were synthesized narratively according to the Synthesis Without Meta-Analysis guidelines, with random-effects meta-analysis for mortality outcomes. Evidence certainty was graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.