Heterogeneity in the response to a high vs low mean arterial pressure target in patients with septic shock a post hoc analysis of a randomized controlled trial
Authors' conclusion
Our results suggest the absence of heterogeneity of the response to different blood pressure targets in patients with septic shock. Targeting a higher MAP target may be associated with harm when high norepinephrine doses are required or when mottled skin is present.
Study context
- Population
- Patients with septic shockenrolled and analysed
- Participants
- 776 patients
- Comparison
- High vs low MAP target
- Primary endpoint
- Mortality
- Follow-up
- Day 28
Methodological detailspost hoc analysis, heterogeneity of treatment effect analysis, multimediation analysis
- Post hoc analysis
- Heterogeneity of treatment effect analysis
- Multimediation analysis
Primary result
As reported in the abstract
Mortality at day 28: HTE and mediation
High MAP target vs Low MAP targetRisk difference (95% CI)
Effect transmitted through high norepinephrine doses
0.027(0.012–0.047)
Effect transmitted through no mottled skin resolution at 24 h
0.012(0.001–0.026)
- Direct effect, 24 h mediators held at control-level values
- RD 0.017 (95% CI - 0.052 to 0.086); P = 0.62
- No evidence of significant heterogeneity of treatment effect (HTE) based on baseline characteristics (sweep p-value)
- 0.664
Original publication
Heterogeneity in the response to a high vs low mean arterial pressure target in patients with septic shock a post hoc analysis of a randomized controlled trial. Intensive Care Med. Published 17 September 2025. doi:10.
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