Hemodynamics, fluids & transfusion
Association between initial norepinephrine dose and minute by minute mean arterial pressure
Authors' conclusion
Higher initial NE doses were associated with both larger and faster MAP increases. Lower starting doses appeared insufficient to achieve a target MAP within 60 min in patients with severe hypotension.
Study context
- Population
- Intensive care unit (ICU) patients with shock (mean arterial pressure (MAP) ≤ 65 mmHg) starting norepinephrine (NE) >30 min after ICU admission, seven ICUs in Japan, 2013–20245,349 received NE, analysed
- Participants
- 81,829 patients
- Exposure
- Initial NE infusion rate 0.100 vs 0.025 and 0.050 µg/kg/min
- Outcome
- Minute-by-minute MAP response to initial NE dose (maximum MAP rise, 15-min rate of increase)
- Follow-up
- 30 min before to 120 min after NE initiation
Methodological detailsgeneralized additive model adjusted for potential confounders
- Generalized additive model adjusted for potential confounders
Main finding
As reported in the abstract
Maximum MAP rise and 15-min rate of increase
0.025 µg/kg/min failed to achieve MAP ≥ 65 mmHg within 60 min when baseline MAP below (mmHg)
53.9
0.050 µg/kg/min failed to achieve MAP ≥ 65 mmHg within 60 min when baseline MAP below (mmHg)
48.4
Observational data: associations, not effects.
Further findings
ICU mortality with failure to achieve MAP ≥ 65 mmHg within 60 min
| OR (CI) | P value | ||
|---|---|---|---|
| Failure to achieve MAP ≥ 65 mmHg within 60 minIndependently associated | 1.49 (1.27–1.76) | P < 0.01 | |
| 0.512Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| Initial MAP slope at 0.025 µg/kg/min (sepsis subgroup)Sepsis vs Non-sepsis · significantly smaller in sepsis | P < 0.01 |
- Initial MAP slope at 0.025 µg/kg/min (sepsis subgroup): 2,006 (37.5%) had sepsis
Original publication
Association between initial norepinephrine dose and minute by minute mean arterial pressure. Crit Care. Published 26 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →