Do we have more guidance on blood pressure targets in the ICU and perioperative settings? What do low or high targets mean? Excellent work Filippo D'Amico Giovanni Landoni, MD and team! Stay tuned for more! Critical Care Medicine

Philippe Rola Good point!

Not all hypotension are the same

Flow=MAP-CVP/R

MAP=CO x R + CVP

Increasing MAP through resistance could reduce flow

1/6🧐 Observational studies have long noted that hypotension is linked to adverse events in perioperative and critical patients, influencing clinical practice and guidelines.

🔗 But is this a true cause-effect relationship, or just bias due to confounding?

🔀 Let’s see what the…

4/10
💥Lower BP targets led to reduced mortality compared to higher targets

13.3% vs 14.4%

RR 0.93, 95% CI, 0.87–0.99

p=0.03

This suggests a significant benefit of lower targets.

Low Versus High Blood Pressure Targets in Critically Ill... : Critical Care Medicine journals.lww.com/ccmjournal/abs… Congrats Giovanni Landoni, MD and the group. #Lessismore #Lower #Better SFAR Anesthésie Réanimation SFAR Jeunes

9/10
🌟 Positive Secondary Outcomes!
Patients with lower BP targets experienced fewer complications:

🫀Lower rate of atrial fibrillation 3.1% vs 4.0% (OR 0.7, p=0.003)

🩸less frequently required transfusion 16.5% vs 20.5% (OR 0.71, p=0.03).

❓Which is the correct BP target in critically ill❓
❌ Probably NOT the most appropriate question‼️
✅ Is blood flow adequate to ensure organ perfusion?
⚠️Interventions to reach a 'comfort zone' BP may lead to higher mortality
#protectivehemodynamics

🔗journals.lww.com/ccmjournal/abs…

1/2
🌟 Highlights: Critically ill patients experiencing even more pronounced benefits with lower BP targets 36.7% vs. 39.7%; RR 0.93, p=.04

🔍 In our study, TSA indicated that the required sample size was achieved in critically ill patients. What does this mean?…

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🚨Low Versus High Blood Pressure Targets in Critically Ill and Surgical Patients

📊Our meta-analysis will redefine how blood pressure is considered in anesthesia and critical care.

This study marks a 'before' and 'after' in our understanding of BP.

Key findings follow

🚀 Just published!

Our new meta-analysis revolutionizes blood pressure management in critical and perioperative patients.

Discover how our findings can change clinical practice. 🔗 journals.lww.com/ccmjournal/abs…

⚡ Breaking new ground in blood pressure management!

🫀 How should we manage blood pressure in critical care and perioperative settings?

📈 Check out our latest meta-analysis, which could redefine how we manage blood pressure in #criticalcare and #perioperative …

🫁🫀Organ #donation after #ECPR

✅ Open access #link

🔗 authors.elsevier.com/c/1izZM14RWGRT…

San Raffaele Anesthesia and Intensive Care ResusBot 🤖❤️⚡️

Our experience in anesthetic management of patients undergoing Caval Valve Implantation

Read our last article on Journal of Cardiothoracic and Vascular Anesthesia at sciencedirect.com/science/articl…

Fabrizio Monaco, MD Marina Pieri Sara Dormio Michele Morosato San Raffaele Anesthesia and Intensive Care San Raffaele Interventional Cardiology Unit

🎧🙇‍♀️If you have a 20min drive to work and you want to improve your knowledge in statistics and methodology this JAMA podcast it’s just perfect!

If you have extra time read also the book from Ed Livingston 📕
“JAMA Guide to statistics and methods”

open.spotify.com/show/15tzVwYQp…

Part of San Raffaele Anesthesia and Intensive Care at #RetreatOSR2024

Directly from #RetreatOSR2024

Poster Session: ‘ #Norepinephrine (base) does not exist.’

Very intriguing results from a national survey in Italy!

#FOAMcc #MedEd #FOAMed

Yesterday morning, we held an interesting #JournalClub session, focusing on AAs IV infusion for #renal #protection

In 1973, Abel et al (NEJM) introduced the potential benefits of AAs on survival, in #AKI pts

Can’t wait for #PROTECTIONtrial results ( #CCR24 - Belfast, June 12th)

💉Amino acids are studied for several purposes, including nutrition, thermogenesis, and shivering.

Probably, the most promising field could be #AKI , slightly neglected after 1973.

📣Stay tuned for the #PROTECTIONtrial results in Belfast #CCR24
🔗 pubmed.ncbi.nlm.nih.gov/36038001/

Are intravenous amino acids a Good strategy for #AKI preveention in cardiac surgery?

🚨SAVE THE DATE 🚨

Belfast. June 12-14, 2024 Critical Care Reviews annual congress

Giovanni Landoni, MD Giacomo Monti Martina Baiardo Redaelli Filippo D'Amico Rosario Losiggio, MDs

Tommaso Scquizzato, MD Resuscitation Matteo Aldo Bonizzoni, MD Marina Pieri Paco Nardelli Alessandro Ortalda Jasmeet Soar Segun Olusanya (He/Him) [email protected] Eduard Argudo Chris Bishop Excellent work and impressive results, Tommaso and colleagues! 👏👏👏👏👏