A new method derived from standard blood pressure assessments can improve monitoring of critically ill patients with circulatory shock, it is reported.
The team behind the breakthrough said it accurately predicts risk of death, length of hospital stay and blood lactate levels.
The work involved designing an approach to measure a property of the circulation called the critical closing pressure, which is the blood pressure at which small blood vessels collapse and blood flow stops.
Critical closing pressure can provide an indication of blood vessel tone in response to disease and therapy, but it has not been possible to measure this parameter routinely in clinical care.
Development of the new approach utilised high-resolution waveform data from blood pressure monitoring of 5532 patients in US cardiac intensive care.
Researchers developed an analysis based on measured parameters to define the critical closing pressure.
They then defined a value called tissue perfusion pressure– the difference between average arterial blood pressure and critical closing pressure – and found that it predicted a patient’s risk of death, length of hospital stay and peak blood lactate.
“We have developed a new metric that can identify individuals with inadequate tissue perfusion who are at risk for adverse outcomes. We believe this method can be used to optimise treatment decisions for patients in the intensive care unit,” said Aaron Aguirre, an Assistant Professor of Medicine at Harvard Medical School.
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