Optimizing Mean Arterial Pressure Targets for Septic Shock Patients With Chronic Hypertension: A Narrative Review

Abstract

Background and Aims: Septic shock is a serious infection-related condition that has a big effect on public health. To improve organ perfusion and prognosis in septic shock patients with chronic high blood pressure, optimal mean arterial pressure (MAP) targets are needed. This narrative review aims to summarize existing knowledge and factors to determine the most effective MAP targets in septic shock patients with chronic hypertension. Methods: A careful review of relevant literature was conducted to understand the factors that affect MAP targets in septic shock patients with chronic hypertension. Long-term hypertension patients require personalized MAP targets based on age, health conditions, and septic shock severity. Results: five studies were identified in this narrative review. Guidelines suggest 65-75 mmHg for most cases, but higher targets may be beneficial for proper organ perfusion. Continuous hemodynamic monitoring allows dynamic adjustment of MAP targets. Conclusion: It is crucial to implement personalized MAP management strategies to achieve optimal outcomes for patients with chronic hypertension who are experiencing septic shock. However, there is a lack of consensus on optimal MAP targets among patients with chronic hypertension, which may require higher MAP targets to maintain adequate tissue perfusion. An approach that considers each patient's unique characteristics and includes ongoing assessment is critical for achieving the best MAP targets and improving patient prognosis.