What’s your target mean arterial pressure (MAP) for patients with sepsis? Do you believe in the magic number of 65? What about those patients with chronic hypertension? What about when there is no evidence of end organ failure?

Currently a lot of this is down to local practice, but international guidelines continue to endorse the magic number.

It’s a little unclear why we put so much faith in this figure; 65 crept into early goal directed work as a target and several retrospective studies have previously suggested a correlation between MAP thresholds in the first 48h of sepsis and survival/organ dysfunction.

However, it’s not the most robust evidence base. And it certainly feels as though we are often chasing a MAP with vasopressors just to make the numbers look good, when other parameters seem to be OK. Let us also not forget that vasopressors are not an entirely benign therapy…

The 65 trial​​ aims to answer the question of whether we have the MAP target right in septic patients aged over 65.

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