Should MAP targets be higher in patients with chronic hypertension?

The SEPSISPAM trial found that targeting MAP 80–85 mmHg in chronic hypertensives reduced AKI (need for renal replacement therapy 38% vs 52%), but did not reduce 28-day mortality. Higher MAP targets may benefit end-organ perfusion in patients dependent on higher perfusion pressures.

What MAP indicates adequate perfusion to avoid vasopressor?

MAP ≥65 mmHg is the standard threshold; however, adequacy of resuscitation should also be confirmed by lactate normalization, urine output ≥0.5 mL/kg/h, and clinical mentation improvement — not MAP alone.

MAP & Vasopressor Targets in Septic Shock

Provides evidence-based MAP targets and vasopressor dosing guidance for septic shock. Standard MAP target: ≥65 mmHg. Consider 80–85 mmHg if chronic hypertension (SEPSISPAM trial). Avoid targeting >75 mmHg in non-hypertensive patients — may increase atrial fibrillation. Target organ perfusion markers (urine output, lactate, mentation) alongside MAP.

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Frequently Asked Questions

Should MAP targets be higher in patients with chronic hypertension?

What MAP indicates adequate perfusion to avoid vasopressor?