Incidence, Severity and Clinical Factors Associated with Hypotension in Patients Admitted to an Intensive Care Unit: A Prospective Observational Study

Background: The majority of patients admitted to the intensive care unit (ICU) experience severe hypotension which is associated with increased morbidity and mortality. At present, prospective studies examining the incidence and severity of hypotension using continuous waveforms are missing. Methods...

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Bibliographic Details
Published in:	Journal of clinical medicine Vol. 11; no. 22; p. 6832
Main Authors:	Terwindt, Lotte E, Schuurmans, Jaap, van der Ster, Björn J P, Wensing, Carin A G C L, Mulder, Marijn P, Wijnberge, Marije, Cherpanath, Thomas G V, Lagrand, Wim K, Karlas, Alain A, Verlinde, Mark H, Hollmann, Markus W, Geerts, Bart F, Veelo, Denise P, Vlaar, Alexander P J
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 18-11-2022 MDPI
Subjects:	Arterial lines Classification Clinical medicine Consent Data collection Hemodynamics Hypotension Intensive care Observational studies Patients Sepsis Software Variables United States > US Switzerland Netherlands arterial waveform hypotension blood pressure area under the threshold cardiovascular monitoring hemodynamics
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Summary:	Background: The majority of patients admitted to the intensive care unit (ICU) experience severe hypotension which is associated with increased morbidity and mortality. At present, prospective studies examining the incidence and severity of hypotension using continuous waveforms are missing. Methods: This study is a prospective observational cohort study in a mixed surgical and non-surgical ICU population. All patients over 18 years were included and continuous arterial pressure waveforms data were collected. Mean arterial pressure (MAP) below 65 mmHg for at least 10 s was defined as hypotension and a MAP below 45 mmHg as severe hypotension. The primary outcome was the incidence of hypotension. Secondary outcomes were the severity of hypotension expressed in time-weighted average (TWA), factors associated with hypotension, the number and duration of hypotensive events. Results: 499 patients were included. The incidence of hypotension (MAP < 65 mmHg) was 75% (376 out of 499) and 9% (46 out of 499) experienced severe hypotension. Median TWA was 0.3 mmHg [0−1.0]. Associated clinical factors were age, male sex, BMI and cardiogenic shock. There were 5 (1−12) events per patients with a median of 52 min (5−170). Conclusions: In a mixed surgical and non-surgical ICU population the incidence of hypotension is remarkably high.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2077-0383 2077-0383
DOI:	10.3390/jcm11226832