Relation between mean arterial pressure and renal function in the early phase of shock: a prospective, explorative cohort study. - 06.11.2015

In 217 patients with sustained hypotension, enrolled and followed prospectively, we compared the evolution of the mean arterial pressure (MAP) during the first 24 hours between patients who will show AKI 72 hours after inclusion (AKIh72 as defined as “Injury” or “Failure” classes of the RIFLE classification [using the creatinine and urine output criteria] or need of renal replacement therapy).
The MAP averaged over H6 to H24 or over H12 to H24 was significantly lower in patients who showed AKIh72 than in those who did not , only in septic shock patients with AKIh6 , whereas no link was found between MAP and AKIh72 in the three others subgroups of patients. In these patients, the best level of MAP to prevent AKIh72 was between 72 and 82 mmHg.
Conclusions
MAP about 72-82 mmHg could be necessary to avoid acute kidney insufficiency in patients with septic shock and initial renal function impairment.

Julie Badin et al.

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