Haemodynamics, fluids & transfusion
Brachial-to-Radial Pressure Gradient in Critically Ill Patients Treated With Vasoactive Agents: A Prospective Observational Study
Authors' conclusion
Nearly one in five critically ill patients receiving vasoactive agents demonstrated a clinically significant NIBR-APG. The presence of this gradient was independently associated with higher vasoactive drug requirements and was accompanied by greater illness severity and higher ICU mortality.
Study context
- Population
- Adult ICU patients with radial arterial catheters receiving vasoactive agents, thirteen ICUs in Poland, April 2025 to July 2025
- Participants
- 303 patients
- Exposure
- Noninvasive brachial-to-radial arterial pressure gradient (NIBR-APG) greater than 11 mm Hg vs Without a significant gradient
- NIBR-APG greater than 11 mm Hgn = 56
- Outcome
- NIBR-APG
Main finding
As reported in the abstract
Median NIBR-APG
4.5 mm Hg
interquartile range, 0.0–10.0 mm Hg
NIBR-APG greater than 11 mm Hg
Fifty-six patients (18.4%)
Observational data: associations, not effects.
Further findings
Norepinephrine-equivalent dose
Capillary refill time
Lactate concentration
Association of vasoactive drug dose with NIBR-APG greater than 11 mm Hg (multivariable analysis)
| OR (95% CI) | ||
|---|---|---|
| Vasoactive drug doseOnly vasoactive drug dose was independently associated · multivariable analysis | 1.68 (1.12–2.52) | |
| 0.20.5125Odds ratio (log scale) |
ICU mortality
| Outcome | NIBR-APG greater than 11 mm Hg | Without a significant gradient |
|---|---|---|
| Sequential Organ Failure Assessment score | 11 | 10 |
Cohort characteristics
- Surgical admissions
- 49.5%
- Septic shock
- 33.3%
Original publication
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