Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

journals.lww.com September 7, 2019

association-between-mean-arterial-pressure-and-acute-kidney-injury-and-a-composite-of-myocardial-injury-and-mortality-in-postoperative-critically-ill-patients

Hypotension thresholds that provoke renal injury, myocardial injury, and mortality in critical care patients remain unknown.

We primarily sought to determine the relationship between hypotension and a composite of myocardial injury and death up to 7 postoperative days.

Secondarily, we considered acute kidney injury (AKI). 2,833 postoperative patients admitted to the surgical ICU.

There was a strong nonlinear (quadratic) association between the lowest mean arterial pressure and the primary outcome of myocardial injury after non-cardiac surgery or mortality, with estimated risk increasing at lower pressures.

Increasing amounts of hypotension (defined by lowest mean arterial pressures per day) were strongly associated with myocardial injury, mortality, and renal injury in postoperative critical care patients.