title: Significance of blood pressure variability in patients with sepsis.
abstract: BACKGROUND
  This study was undertaken to observe the characteristics of blood pressure variability (BPV) and sepsis and to investigate changes in blood pressure and its value on the severity of illness in patients with sepsis.
  
  
  METHODS
  Blood parameters, APACHE II score, and 24-hour ambulatory BP were analyzed in 89 patients with sepsis.
  
  
  RESULTS
  In patients with APACHE II score>19, the values of systolic blood pressure (SBPV), diasystolic blood pressure (DBPV), non-dipper percentage, cortisol (COR), lactate (LAC), platelet count (PLT) and glucose (GLU) were significantly higher than in those with APACHE II score ≤19 (P<0.05), whereas the values of procalcitonin (PCT), white blood cell (WBC), creatinine (Cr), PaO2, C-reactive protein (CRP), adrenocorticotropic hormone (ACTH) and tumor necrosis factor α (TNF-α) were not statistically significant (P>0.05). Correlation analysis showed that APACHE II scores correlated significantly with SBPV and DBPV (P<0.01, r=0.732 and P<0.01, r=0.762). SBPV and DBPV were correlated with COR (P=0.018 and r=0.318; P=0.008 and r=0.353 respectively). However, SBPV and DBPV were not correlated with TNF-α, IL-10, and PCT (P>0.05). Logistic regression analysis of SBPV, DBPV, APACHE II score, and LAC was used to predict prognosis in terms of survival and non-survival rates. Receiver operating characteristics curve (ROC) showed that DBPV was a better predictor of survival rate with an AUC value of 0.890. However, AUC of SBPV, APACHE II score, and LAC was 0.746, 0.831 and 0.915, respectively.
  
  
  CONCLUSIONS
  The values of SBPV, DBPV and non-dipper percentage are higher in patients with sepsis. DBPV and SBPV can be used to predict the survival rate of patients with sepsis.
authors.affiliation: Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Nishant Raj
authors.initials: NR
authors.lastname: Pandey
authors.affiliation: Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Yu-Yao
authors.initials: YY
authors.lastname: Bian
authors.affiliation: Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Song-Tao
authors.initials: ST
authors.lastname: Shou
keywords: APACHE II score; Diastolic blood pressure variability; Inflammatory factor; Sepsis; Systolic blood pressure variability