Blood pressure and acute kidney injury.
Maintaining the optimal blood pressure is an important aspect of preventing acute kidney injury (AKI), especially for vasopressor-dependent patients. Although mean arterial pressure (MAP) has played an important role in previous trials for prevention of AKI, there is little evidence that MAP actually reflects organ perfusion. In fact, several studies have suggested that perfusion pressure, including diastolic perfusion pressure and mean perfusion pressure (MPP) and calculated with central venous pressure (CVP), may be more useful than the widely used MAP to help prevent AKI. This emphasizes the importance of maintaining diastolic arterial pressure and avoiding elevation of CVP to prevent AKI in patients with sepsis or invasive surgery. To achieve this, further investigation regarding titrated fluid therapy and vasopressors is warranted.
Department of Emergency and Critical Care Medicine, Urasoe General Hospital, 4-16-1, Iso, Urasoe, Okinawa, 901-2131, Japan. st051035@gmail.com.
Ryota
R
Sato
Department of Anesthesia, Urasoe General Hospital, Okinawa, Japan.
Sarah Kyuragi
SK
Luthe
Department of Emergency and Critical Care Medicine, Urasoe General Hospital, 4-16-1, Iso, Urasoe, Okinawa, 901-2131, Japan.
Michitaka
M
Nasu
D058186:Acute Kidney Injury / Q000209:etiology / Q000503:physiopathology*; D062186:Arterial Pressure / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D002496:Central Venous Pressure / Q000502:physiology; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D014662:Vasoconstrictor Agents / Q000494:pharmacology / Q000627:therapeutic use
D014662:Vasoconstrictor Agents
Acute kidney injury; Central venous pressure; Diastolic perfusion pressure; Mean arterial pressure; Mean perfusion pressure