{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:34:20Z","timestamp":1761093260631,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T00:00:00Z","timestamp":1696032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>To compare guideline\u2010based fluid resuscitation and need for respiratory support escalation in septic patients with pulmonary hypertension (PH) to those without PH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Single\u2010center, retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care academic medical center in Detroit, Michigan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Adult patients with or without PH hospitalized and diagnosed with sepsis from November 1, 2013 through December 31, 2019. Patients with sepsis were assigned to one of two groups based on a previous PH diagnosis or no PH diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>None.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>The primary outcome was incidence of respiratory support escalation within 72 h from sepsis time zero. Respiratory support escalation included high\u2010flow nasal cannula, bilevel positive airway pressure, or intubation. One\u2010hundred and four patients were included with 52 patients in each study group. Patients with PH were more likely to require escalation of respiratory support compared to non\u2010PH patients (32.7% vs. 11.5%; <jats:italic>p<\/jats:italic>\u2009=\u20090.009). Fewer patients with PH received 30 mL\/kg of crystalloid within 6 h of time zero compared with non\u2010PH patients (3.8% vs. 42.3%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Vasopressor initiation was more common in patients with PH compared with the non\u2010PH group (40.4% vs. 19.2%; <jats:italic>p<\/jats:italic>\u2009=\u20090.018). PH diagnosis was the only independent predictor of respiratory support escalation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>During initial sepsis management when compared with patients without PH, patients with PH had increased instances of respiratory support escalation within 72\u2009h of sepsis time zero despite lower fluid resuscitation volumes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2879","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T07:05:21Z","timestamp":1695193521000},"page":"61-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fluid resuscitation and relation to respiratory support escalation in patients with and without pulmonary hypertension with sepsis"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3397-1159","authenticated-orcid":false,"given":"Mary 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