{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T21:17:27Z","timestamp":1779139047265,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Intensive Care Society"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In sepsis and cardiac arrest, arterial hypotension is associated with poorer outcomes, including renal injury and mortality. Guidelines recommend a mean arterial pressure (MAP) target of \u2a7e65\u2009mmHg, but supporting evidence is limited. We undertook a service evaluation which aimed to: (1) assess clinical opinion regarding the optimal MAP target in intensive care (ICU); and (2) evaluate MAP target adherence at the Royal Infirmary Edinburgh ICU, quantifying levels of hypotension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We utilised a concurrent triangulation mixed-methods approach, integrating semi-structured consultant interviews and quantitative analysis of patient-level blood pressure data. Blood pressure data were collected at 1-min intervals for the first 72\u2009h of arterial monitoring. We defined hypotensive insults by five sequential minutes below MAP target.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We interviewed 18 consultants. Twelve (67%) reported a standard target of 65\u2009mmHg. The importance of evidence-based, individualised, and flexible targets was emphasised. We included 208,570\u2009min of monitoring time across 66 patients. At admission, 53 (80%) patients received a target of 65\u2009mmHg. Mean (SD) MAP was lower in patients on vasopressors than those not on vasopressors (77.6 (14.2) vs 86.9 (17.3)\u2009mmHg,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0001). Hypotension affected 55 (83%) patients and accounted for &gt;10% of monitoring time in thirteen (20%). Median pressure-time index (PTI) was 3.4\u2009mmHg\u2009*\u2009h; 24 (36%) patients had a PTI &gt;10\u2009mmHg\u2009*\u2009h.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The optimal MAP target varied by patient, yet target personalisation remained limited in practice. Target adherence varied, with observed MAP both exceeding and undershooting set targets. Future research will explore the feasibility and implications of achieving tighter blood pressure control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17511437261415835","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T16:00:41Z","timestamp":1771084841000},"page":"187-197","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Targeting and monitoring mean arterial pressure in critical illness: A mixed-methods service evaluation"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6558-2062","authenticated-orcid":false,"given":"Isla","family":"MacKay","sequence":"first","affiliation":[{"name":"Edinburgh Medical School, University of Edinburgh, U"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Piper","sequence":"additional","affiliation":[{"name":"Centre for Medical Informatics, Usher Institute, University of Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemarie B.","family":"Docherty","sequence":"additional","affiliation":[{"name":"Centre for Medical Informatics, Usher Institute, University of Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.05.023"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1427-2"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.07.019"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.10.008"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4683-6"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06368-4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5292-8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2531-2"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000059722.94182.79"},{"key":"e_1_3_3_11_2","first-page":"334","article-title":"Personalised haemodynamic management","volume":"23","author":"Saugel B","year":"2017","unstructured":"Saugel B, Vincent JL, Wagner JY. Personalised haemodynamic management. Curr Opin Crit Care 2017; 23: 334\u2013341.","journal-title":"Curr Opin Crit Care"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-015-0085-5"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1312173"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5852.507"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0930"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917733847"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04322-y"},{"key":"e_1_3_3_18_2","unstructured":"Mindray Central Monitoring System. Mindray [Internet] https:\/\/www.mindray.com\/uk\/products\/patient-monitoring\/centralized-monitoring\/benevision-cms (1991 accessed 16 October 2024)."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008506-199401000-00001"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11030849"},{"key":"e_1_3_3_21_2","unstructured":"Brain Trauma Foundation. Guidelines for the management of severe TBI [Internet] https:\/\/braintrauma.org\/coma\/guidelines\/guidelines-for-the-management-of-severe-tbi-4th-ed (2021 accessed 13 April 2024)."},{"key":"e_1_3_3_22_2","unstructured":"NHS Scotland. Management of patients with acute Type B aortic dissection [Internet] https:\/\/rightdecisions.scot.nhs.uk\/media\/pymfiouc\/type-b-thoracic-dissection-flowchart-2023.pdf (2023 accessed 13 April 2024)."},{"key":"e_1_3_3_23_2","unstructured":"Das JM Anosike K Waseem M. Permissive hypotension. 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