{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T01:15:57Z","timestamp":1793495757532,"version":"4.5.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,1,28]],"date-time":"2024-01-28T00:00:00Z","timestamp":1706400000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Massachusetts Department of Public Health Spinal Cord Injury Cure Research Program"},{"name":"University of Maryland UM Ventures Seed Grant"},{"name":"Nihon Kohden Innovation Center"},{"name":"Mass General Brigham Innovations"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>Background: Published evidence indicates that mean arterial pressure (MAP) below a goal range (hypotension) is associated with worse outcomes, though MAP management failures are common. We sought to characterize hypotension occurrences in ICUs and consider the implications for MAP management. Methods: Retrospective analysis of 3 hospitals\u2019 cohorts of adult ICU patients during continuous vasopressor infusion. Two cohorts were general, mixed ICU patients and one was exclusively acute spinal cord injury patients. \u201cHypotension-clusters\u201d were defined where there were \u226510\u2005min of cumulative hypotension over a 60-min period and \u201cconstant hypotension\u201d was \u226510 continuous minutes. Trend analysis was performed (predicting future MAP using 14\u2005min of preceding MAP data) to understand which hypotension-clusters could likely have been predicted by clinician awareness of MAP trends. Results: In cohorts of 155, 66, and 16 ICU stays, respectively, the majority of hypotension occurred within the hypotension-clusters. Failures to keep MAP above the hypotension threshold were notable in the bottom quartiles of each cohort, with hypotension durations of 436, 167, and 468\u2005min, respectively, occurring within hypotension-clusters per day. Mean arterial pressure trend analysis identified most hypotension-clusters before any constant hypotension occurred (81.2%-93.6% sensitivity, range). The positive predictive value of hypotension predictions ranged from 51.4% to 72.9%. Conclusions: Across 3 cohorts, most hypotension occurred in temporal clusters of hypotension that were usually predictable from extrapolation of MAP trends.<\/jats:p>","DOI":"10.1177\/08850666241226893","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T01:49:11Z","timestamp":1706492951000},"page":"683-692","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Hypotension During Vasopressor Infusion Occurs in Predictable Clusters: A Multicenter Analysis"],"prefix":"10.1177","volume":"39","author":[{"given":"Daisuke","family":"Horiguchi","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA"},{"name":"Nihon Kohden Innovation Center, LLC, Cambridge, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9054-5666","authenticated-orcid":false,"given":"Sungtae","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Maryland, College Park, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy A.","family":"Pepino","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0834-5076","authenticated-orcid":false,"given":"Iain E.","family":"Kehoe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua N.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4532-8523","authenticated-orcid":false,"given":"Jarone","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA"},{"name":"Department of Surgery, Massachusetts General Hospital, Boston MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian K.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Oh","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Maryland, College Park, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Reisner","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,1,28]]},"reference":[{"key":"bibr1-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2769-8"},{"issue":"18","key":"bibr2-08850666241226893","volume":"122","author":"Peberdy MA","year":"2010","journal-title":"Circulation"},{"key":"bibr3-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2008.11760744"},{"key":"bibr4-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000430319.32247.7f"},{"key":"bibr5-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1172\/JCI102997"},{"key":"bibr6-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.37.5.550"},{"key":"bibr7-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002300"},{"key":"bibr8-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2014.3778"},{"key":"bibr9-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318265ea46"},{"key":"bibr10-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2022.110981"},{"issue":"5445351","key":"bibr11-08850666241226893","first-page":"541","volume":"36","author":"Moody G","year":"2009","journal-title":"Comput Cardiol"},{"key":"bibr12-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1186\/cc13161"},{"key":"bibr13-08850666241226893","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11195551"},{"key":"bibr14-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.09.041"},{"key":"bibr15-08850666241226893","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_624_19"},{"key":"bibr16-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-08137-0"},{"key":"bibr17-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03379-3"},{"key":"bibr18-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-021-00778-x"},{"key":"bibr19-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.23.e215"},{"key":"bibr20-08850666241226893","doi-asserted-by":"publisher","DOI":"10.3171\/2008.10.SPINE08217"},{"key":"bibr21-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijforecast.2003.09.015"},{"key":"bibr22-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-020-00559-7"},{"key":"bibr23-08850666241226893","first-page":"293","volume-title":"Advances in Patient Safety: From Research to Implementation (Volume 2: Concepts and Methodology)","author":"O'Connor PJ","year":"2005"},{"key":"bibr24-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-020-09979-z"},{"key":"bibr25-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003557"},{"key":"bibr26-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.05.033"},{"key":"bibr27-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0592"},{"key":"bibr28-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002581"},{"key":"bibr29-08850666241226893","first-page":"545","volume":"36","author":"Chen X","year":"2009","journal-title":"Comput Cardiol"},{"key":"bibr30-08850666241226893","first-page":"549","volume":"36","author":"Henriques J","year":"2009","journal-title":"Comput Cardiol"},{"key":"bibr31-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001693"},{"key":"bibr32-08850666241226893","first-page":"498","author":"Shin S","year":"2019","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"bibr33-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.08.023"},{"key":"bibr34-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1186\/cc13133"},{"key":"bibr35-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5218-5"},{"key":"bibr36-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003474"},{"key":"bibr37-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182a10e26"},{"key":"bibr38-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000196957.55928.ab"},{"key":"bibr39-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181b9e1a5"},{"key":"bibr40-08850666241226893","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12004"}],"container-title":["Journal of Intensive Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666241226893","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08850666241226893","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666241226893","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:57:57Z","timestamp":1777503477000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08850666241226893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,28]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1177\/08850666241226893"],"URL":"https:\/\/doi.org\/10.1177\/08850666241226893","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2022.08.25.22279077","asserted-by":"object"}]},"ISSN":["0885-0666","1525-1489"],"issn-type":[{"value":"0885-0666","type":"print"},{"value":"1525-1489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,28]]}}}