IncreasedMAPinSepsis

A mean arterial blood pressure (MAP) target of 65 mm Hg in severe sepsis and shock is recommended by the International Guidelines for Management of Severe Sepsis. The guidelines writers made a grade 1C recommendation, and advise to consider a higher goal for patients with a history of hypertension or atherosclerosis. A randomized study recently published in the NEJM using a higher MAP goal, 80-85 mm Hg, compared to a MAP of 65-70 mm Hg in sepsis did not result in improved outcomes or changes in adverse events. However, in a subgroup analysis, patients with chronic hypertension had less AKI and need for dialysis in the higher MAP group.