Mean arterial pressure in critically ill adults receiving vasopressors: A multicentre, observational study
Bibliographic record
Abstract
Objective: Mean arterial pressure (MAP) management is a key aspect of treatment in critically ill patients receiving vasopressor therapy. Guidelines in different clinical subgroups have proposed various target MAP values. This study aimed to describe delivered MAP values and corresponding vasopressor doses in such patients. Design: Multicenter, retrospective cohort study of adult intensive care unit (ICU) admissions. Setting: 12 ICUs in Queensland, Australia, from January 1, 2015, to December 31, 2021. Participants: Patients receiving vasopressors for at least six continuous hours in the ICU. We studied the delivered MAP values using hourly data based on averaging all validated values obtained from the ICU monitors and average hourly doses of vasopressors. Main Outcome Measure: The primary outcome was the mean MAP during the entire cohort's first 72 hours of ICU admission, whilst vasopressors were administered. Results: In 26,519 patients who received vasopressors for at least six continuous hours, the median age was 62 years, and 9,373 (35%) were admitted after elective surgery. The median time from ICU admission to vasopressor commencement was 2 hours, and the median duration of vasopressor therapy was 27 hours. At 72 hours, 6,627 (25.0%) patients remained on vasopressors. The mean hourly MAP was 72 mmHg in the first six hours, then steadily increased to ≈75 mmHg at 72 hours. In the first 72 hours, 11,032 (41.6%) patients had a mean MAP of 70-74 mmHg, and 5,914 (22.3%) had a mean MAP of 75-79 mmHg. For every clinical subgroup, a MAP of 70-74 mmHg was the most common mean MAP, and the proportion of patients with a mean MAP of 60-65mmHg was less than 5%. Conclusions: In a large, multicenter study of heterogeneous critically ill patients on vasopressors, the mean hourly MAP was > 70 mmHg. This mean hourly MAP was observed consistently over diverse clinical subgroups and is higher than recommended by guidelines.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".