Assessment of Tissue Perfusion Pressure in Patients With Septic Shock: Beyond Mean Arterial Pressure
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Le résumé fourni par la source
OBJECTIVES: Optimization of macrohemodynamics is just the starting point in the management of hemodynamics in patients with septic shock. We describe the interaction between the various determinants of arterial pressure and tissue perfusion, how to optimize them and their estimations at the bedside. This is a concise definitive review of the assessment of tissue perfusion pressure (TPP) in patients with septic shock beyond just mean arterial pressure (MAP). DATA SOURCES: Original publications were retrieved through a PubMed and MEDLINE databases with search terms related to septic shock, arterial blood pressure, critical closing pressure (Pcc), mean systemic filling pressure (Pmsf), and TPP. Supporting evidence was also retrieved from PubMed and MEDLINE when indicated. STUDY SELECTION: English-language systematic reviews, narrative reviews, meta-analyses, randomized clinical trials, and observational studies. DATA EXTRACTION AND DATA SYNTHESIS: Data from relevant publications were reviewed, selected, and summarized by the authors and applied as indicated. CONCLUSIONS: The relationship between arterial pressure and outcomes in septic shock is complex and heterogeneous. Focusing on critical parameters-such as TPP, the vascular waterfall, and individual treatment effects-enables a more personalized approach, focused on perfusion rather than pressure alone. Persistent hypoperfusion despite adequate macrocirculatory targets marks a pivotal moment when microcirculatory assessment becomes essential to guide therapy and avoid potentially harmful escalation of fluids or vasopressors. Bedside measurements of systolic arterial pressure, MAP, diastolic arterial pressure, Pcc, and Pmsf offer practical tools for monitoring and tailoring treatment. Future clinical trials are needed to validate these metrics and refine resuscitation strategies in septic shock.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Assessment of Tissue Perfusion Pressure in Patients With Septic Shock: Beyond Mean Arterial Pressure
- Date Crossref
- 23/07/2025
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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King Faisal Specialist Hospital & Research Centre Organ Transplant Center of Excellence pays non établi dans la noticeÉtablissement de santé
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Technology Innovation Institute pays non établi dans la noticeStructure de recherche
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Cleveland Clinic Abu Dhabi pays non établi dans la noticeÉtablissement de santé
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Alfaisal University pays non établi dans la noticeUniversité ou école supérieure
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Pontificia Universidad Católica de Chile pays non établi dans la noticeUniversité ou école supérieure
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University of Pittsburgh Department of Critical Care Medicine pays non établi dans la noticeUniversité ou école supérieure
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Critical Care Institute pays non établi dans la noticeStructure de recherche
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College of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Departamento de Medicina Intensiva pays non établi dans la noticeInstitution
Organ Transplant Center of Excellence — King Faisal Specialist Hospital & Research Centre, Technology Innovation Institute et Cleveland Clinic Abu Dhabi, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.