SEPSISPAM
High versus Low Blood-Pressure Target in Patients with Septic Shock
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 776 patients with septic shock, targeting MAP 80–85 mm Hg did not change 28-day mortality versus MAP 65–70 mm Hg, but reduced renal-replacement therapy in chronic hypertension.
N
776
Schéma
Multicentre RCT, France
Critère
28-day mortality
Pertinence
2
Résultat36.6% vs 34.0% (HR 1.07; 95% CI 0.84–1.38; p=0.57). More new atrial fibrillation with the higher target. Pre-specified chronic-hypertension subgroup: less creatinine doubling and less RRT.
Asfar P, et al. N Engl J Med. 2014;370(17):1583-1593. 10.1056/NEJMoa1312173
Discussion et critique
Default MAP ≥65 mm Hg; consider 80–85 in long-standing hypertension.