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Mean arterial pressure targets in intensive care unit patients receiving noradrenaline: An international survey

Young PJ 1 , Bellomo R 2 , Al-Fares A 3 , Antognini DG 4 , Arabi YM 5 , Ashraf MS 6 Show all authors , Bagshaw SM 7 , Brown AJ 2 , Buabbas S 8 , Campbell L 9 , Chen JM 10 , Freebairn RC 11 , Fujii T 2 , Hasan MS 12 , Jain A 13 , Lai NA 14 , Lakhey S 15 , Partlin MM 16 , Marment S 17 , McCullough JPA 18 , Nichol AD 19 , Ramanan M 20 , Regmi A 21 , Saxena M 22 , Seppelt I 23 , Shima N 24 , Twardowski P 25 , White KC 26 , Lamontagne F 27

Affiliations 

  • 1 Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
  • 2 Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
  • 3 Department of Anesthesia, Critical Care Medicine, and Pain Medicine, Al-Amiri Hospital, Ministry of Health, Kuwait
  • 4 Department of Intensive Care, Monash Health - Victorian Heart Hospital / Monash Medical Centre, Melbourne, Australia
  • 5 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and Intensive Care Department, King Abdulaziz Medical City, Ministry of National-Guard Health Affairs, Riyadh, Saudi Arabia
  • 6 Department of Anesthesia and Critical Care Unit, Lady Reading Hospital, Peshawar, Pakistan
  • 7 Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Alberta Health Services, Edmonton, Alberta, Canada
  • 8 Department of Anaesthesia, Critical Care Medicine and Pain Medicine, Jaber Alahmad Alsabah Hospital, Kuwait
  • 9 Charles Darwin University and Royal Darwin Hospital, Darwin, Northern Territory, Australia
  • 10 Intensive Care Unit, Tauranga Hospital, Te Whatu Ora Hauora a Toi Bay of Plenty, Tauranga, New Zealand
  • 11 Intensive Care Unit, Hawke's Bay Hospital, Hastings, New Zealand
  • 12 Department of Anaesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
  • 13 Medicover Hospital, Mumbai, India
  • 14 Intensive Care Services, Mater Health, Queensland, Australia
  • 15 Department of Critical Care, B & B Hospital, Kathmandu, Nepal
  • 16 Wollongong Hospital, New South Wales, Australia
  • 17 Sunshine Coast University Hospital, Queensland, Australia
  • 18 Intensive Care Unit, Gold Coast University Hospital, Queensland, Australia
  • 19 University College Dublin Clinical Research Centre and St Vincents University Hospital, Dublin, Ireland
  • 20 Caboolture Hospital, Metro North Hospital and Health Services, Brisbane, Queensland, Australia
  • 21 Al Zahra Hospital, Dubai, United Arab Emirates
  • 22 St George Hospital Clinical School and The Critical Care Program, The George Institute for Global Health, University of New South Wales, Sydney, Australia
  • 23 Nepean Clinical School, University of Sydney, New South Wales, Australia
  • 24 Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
  • 25 Southern Critical Care, Dunedin Public Hospital, Dunedin, New Zealand
  • 26 Princess Alexandra Hospital, Woolloongabba, Australia
  • 27 Université de Sherbrooke, Quebec, Canada
Crit Care Resusc, 2025 Mar;27(1):100095.
PMID: 40109286 DOI: 10.1016/j.ccrj.2024.12.001

Abstract

OBJECTIVE: This study aimed to evaluate intensive care doctors' views about a large-scale pragmatic minimum mean arterial pressure (MAP) targets trial and their attitudes and beliefs about minimum MAP targets in different clinical scenarios.

DESIGN: An online survey was conducted.

SETTING AND PARTICIPANTS: An online survey was distributed to intensive care doctors in sites participating in a large-scale international randomised clinical trial evaluating oxygen therapy targets in 15 countries and to additional intensive care clinicians from Canada.

MAIN OUTCOME MEASURES: Outcomes included the expressed level of support for a large pragmatic trial to evaluate minimum MAP targets in critically ill adults and stated current practice and acceptability of minimum MAP for specific scenarios.

RESULTS: The response rate to our survey for respondents who work in sites participating in the mega randomised registry trial research program was 265 out of 701 (37.8%), with an additional 56 out of 256 (21.8%) responses obtained from a direct email containing a link to the survey sent to intensive care clinicians in Canada. A total of 309 of 321 respondents (96.3%) were supportive, in principle, of conducting a very large pragmatic trial to evaluate MAP targets in intensive care unit patients receiving noradrenaline. The commonest response in all scenarios was to agree that the optimal minimum MAP target was uncertain. In all scenarios, except for active bleeding, the most common reported minimum MAP target was 65 mmHg; for patients who were actively bleeding, the most common reported target was 60 mmHg.

CONCLUSIONS: Our data suggest that intensive care clinicians are broadly supportive of a large-scale pragmatic minimum MAP targets in intensive care unit patients receiving noradrenaline.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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