• Zichen Wang, Luming Zhang, Wen Ma, Hao Wang, Haiyan Yin, and Jun Lyu.
• Departamento de la Unidad de Cuidados Intensivos, Primer Hospital Afiliado a la Universidad de Jinan, Guangzhou, Provincia de Guangdong, China. Servicio de Salud Pública, Universidad de California, Irvine, California, EE.UU.
• Emergencias. 2022 Oct 1; 34 (5): 331-338.

ObjectivesTo analyze the association between blood pressure during vasopressor weaning and in-hospital mortality in patients admitted to an intensive care unit (ICU).Material And MethodsObservational retrospective single-center study including patient data registered in the Medical Information Mart for Intensive Care, version 4. The outcome was in-hospital mortality. We used restricted cubic spline (RCS) functions to analyze the associations between mortality and systolic and diastolic blood pressures and mean arterial pressure (SBP, DBP, and MAP, respectively) during weaning from vasopressors. The data was stratified a ccording t o SBP, DBP, and MAP, and sensitivity was assessed with Cox regression analysis.ResultsData for 8294 patients were analyzed. The RCS functions showed that SBP, DBP, and MAP values had nonlinear U-shaped associations with in-hospital mortality. Patients were classified into the following subgroups according to points of intersection of SBP, DBP, and MAP reference values: SBP 110, 110-150, or >150 mmHg; DBP 60, 60-85, or >85 mmHg; and MAP 75, 75-110, or >110 mmHg. In the lowest blood pressure group the hazard ratio was 0.59 (95% CI, 0.52-0.66) for SBP in the 110-150 mmHg range; 0.62 (95% CI, 0.55-0.70) for DBP in the 60-85 mmHg range; and 0.64 (95% CI, 0.57-0.72) for MAP in the 75-110 mmHg range during weaning. The analysis of subgroups also indicated that blood pressures during weaning interacted with cerebral vascular disease and chronic obstructive pulmonary disease.ConclusionHigher blood pressures during vasopressor weaning are associated with longer in-hospital survival in ICU patients. The optimum pressure ranges are SBP, 110-150 mmHg; DBP, 60-85 mmHg; and MAP, 75-110 mmHg. Blood pressures may behave differently according to diagnosis.

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