| Title |
A systematic review of vasopressor blood pressure targets in critically ill adults with hypotension
|
|---|---|
| Published in |
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, May 2017
|
| DOI | 10.1007/s12630-017-0877-1 |
| Pubmed ID | |
| Authors |
Mathieu Hylands, Morten Hylander Moller, Pierre Asfar, Augustin Toma, Anne Julie Frenette, Nicolas Beaudoin, Émilie Belley-Côté, Frédérick D’Aragon, Jon Henrik Laake, Reed Alexander Siemieniuk, Emmanuel Charbonney, François Lauzier, Joey Kwong, Bram Rochwerg, Per Olav Vandvik, Gordon Guyatt, François Lamontagne |
| Abstract |
Clinicians must balance the risks from hypotension with the potential adverse effects of vasopressors. Experts have recommended a mean arterial pressure (MAP) target of at least 65 mmHg, and higher in older patients and in patients with chronic hypertension or atherosclerosis. We conducted a systematic review of randomized-controlled trials comparing higher vs lower blood pressure targets for vasopressor therapy administered to hypotensive critically ill patients. We searched MEDLINE®, EMBASE™, and the Cochrane Central Register of Controlled Trials for studies of higher vs lower blood pressure targets for vasopressor therapy in critically ill hypotensive adult patients. Two reviewers independently assessed trial eligibility based on titles and abstracts, and they then selected full-text reports. Outcomes, subgroups, and analyses were prespecified. We used GRADE (Grading of Recommendations Assessment, Development and Evaluation) to rate the overall confidence in the estimates of intervention effects. Of 8001 citations, we retrieved 57 full-text articles and ultimately included two randomized-controlled trials (894 patients). Higher blood pressure targets were not associated with lower mortality (relative risk [RR], 1.05; 95% confidence interval [CI], 0.90 to 1.23; P = 0.54), and neither age (P = 0.17) nor chronic hypertension (P = 0.32) modified the overall effect. Nevertheless, higher blood pressure targets were associated with a greater risk of new-onset supraventricular cardiac arrhythmia (RR, 2.08; 95% CI, 1.28 to 3.38; P < 0.01). Current evidence does not support a MAP target > 70 mmHg in hypotensive critically ill adult patients requiring vasopressor therapy. |
X Demographics
The data shown below were collected from the profiles of 27 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 6 | 22% |
| Canada | 6 | 22% |
| United States | 2 | 7% |
| Australia | 1 | 4% |
| Jamaica | 1 | 4% |
| Kenya | 1 | 4% |
| United Arab Emirates | 1 | 4% |
| Germany | 1 | 4% |
| Unknown | 8 | 30% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 18 | 67% |
| Practitioners (doctors, other healthcare professionals) | 4 | 15% |
| Science communicators (journalists, bloggers, editors) | 3 | 11% |
| Scientists | 2 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 35 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 7 | 20% |
| Student > Postgraduate | 5 | 14% |
| Student > Bachelor | 4 | 11% |
| Student > Master | 3 | 9% |
| Student > Ph. D. Student | 2 | 6% |
| Other | 7 | 20% |
| Unknown | 7 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 54% |
| Nursing and Health Professions | 2 | 6% |
| Unspecified | 1 | 3% |
| Computer Science | 1 | 3% |
| Neuroscience | 1 | 3% |
| Other | 2 | 6% |
| Unknown | 9 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 20. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 February 2022.
All research outputs
#1,881,665
of 25,382,440 outputs
Outputs from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#242
of 2,878 outputs
Outputs of similar age
#35,350
of 325,438 outputs
Outputs of similar age from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#4
of 45 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,878 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one has done particularly well, scoring higher than 91% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 325,438 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 45 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 91% of its contemporaries.