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TY - JOUR

T1 - Definition and incidence of hypotension in intensive care unit patients, an international survey of the European Society of Intensive Care Medicine

AU - Cardiovascular Dynamics Section of the ESICM

AU - Schenk, J

AU - van der Ven, W H

AU - Schuurmans, J

AU - Roerhorst, S

AU - Cherpanath, T G V

AU - Lagrand, W K

AU - Thoral, P

AU - Elbers, P W G

AU - Tuinman, P R

AU - Scheeren, T W L

AU - Bakker, J

AU - Geerts, B F

AU - Veelo, D P

AU - Paulus, F

AU - Vlaar, A P J

N1 - Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/10/1

Y1 - 2021/10/1

N2 - Introduction: Although hypotension in ICU patients is associated with adverse outcome, currently used definitions are unknown and no universally accepted definition exists. Methods: We conducted an international, peer-reviewed survey among ICU physicians and nurses to provide insight in currently used definitions, estimations of incidence, and duration of hypotension. Results: Out of 1394 respondents (1055 physicians (76%) and 339 nurses (24%)), 1207 (82%) completed the questionnaire. In all patient categories, hypotension definitions were predominantly based on an absolute MAP of 65 mmHg, except for the neuro(trauma) category (75 mmHg, p < 0.001), without differences between answers from physicians and nurses. Hypotension incidence was estimated at 55%, and time per day spent in hypotension at 15%, both with nurses reporting higher percentages than physicians (estimated mean difference 5%, p = 0.01; and 4%, p < 0.001). Conclusions: An absolute MAP threshold of 65 mmHg is most frequently used to define hypotension in ICU patients. In neuro(trauma) patients a higher threshold was reported. The majority of ICU patients are estimated to endure hypotension during their ICU admission for a considerable amount of time, with nurses reporting a higher estimated incidence and time spent in hypotension than physicians.

AB - Introduction: Although hypotension in ICU patients is associated with adverse outcome, currently used definitions are unknown and no universally accepted definition exists. Methods: We conducted an international, peer-reviewed survey among ICU physicians and nurses to provide insight in currently used definitions, estimations of incidence, and duration of hypotension. Results: Out of 1394 respondents (1055 physicians (76%) and 339 nurses (24%)), 1207 (82%) completed the questionnaire. In all patient categories, hypotension definitions were predominantly based on an absolute MAP of 65 mmHg, except for the neuro(trauma) category (75 mmHg, p < 0.001), without differences between answers from physicians and nurses. Hypotension incidence was estimated at 55%, and time per day spent in hypotension at 15%, both with nurses reporting higher percentages than physicians (estimated mean difference 5%, p = 0.01; and 4%, p < 0.001). Conclusions: An absolute MAP threshold of 65 mmHg is most frequently used to define hypotension in ICU patients. In neuro(trauma) patients a higher threshold was reported. The majority of ICU patients are estimated to endure hypotension during their ICU admission for a considerable amount of time, with nurses reporting a higher estimated incidence and time spent in hypotension than physicians.

KW - Blood pressure

KW - Critical care

KW - Hypotension

KW - Intensive care units

KW - Surveys and questionnaires

UR - http://www.scopus.com/inward/record.url?scp=85108072635&partnerID=8YFLogxK

U2 - 10.1016/j.jcrc.2021.05.023

DO - 10.1016/j.jcrc.2021.05.023

M3 - Article

C2 - 34148010

VL - 65

SP - 142

EP - 148

JO - Journal of critical care

JF - Journal of critical care

SN - 0883-9441

ER -