Renal Resistive Index Responsiveness to a Mean Arterial Pressure Test As a Guide for Mean Arterial Pressure Target in the Early Phase of Septic Shock: A Physiological Study
Authors' conclusion
In early septic shock, a decrease in RRI during a MAP test did not identify patients who would benefit from higher MAP targets to improve renal function. Conversely, the absence of an RRI decrease during the MAP test may help identify patients in whom increasing MAP is associated with increased urine output.
Study context
- Population
- Early septic shock (norepinephrine ≥ 0.05 µg/kg/min within 9 hr of initiation) without CKD or immediate need for RRT, medical ICU of a university hospital23 (29%) renal resistive index (RRI) responders
- Participants
- 80 participants
- Comparison
- Low vs High
Methodological detailsstratified by RRI response, single-centre, Standardized 2-hour mean arterial pressure (MAP) test (65-70 then 80-85 mm Hg) with RRI measured at each period; RRI responders = RRI decrease ≥ 0.05
- Stratified by RRI response
- Single-centre
- Standardized 2-hour MAP test (65-70 then 80-85 mm Hg) with RRI measured at each period; RRI responders = RRI decrease ≥ 0.05
Primary result
As reported in the abstract
Renal outcomes by RRI response (diuresis, KDIGO stage, RRT, serum creatinine)
- RRI responders: higher MAP target not associated with improved renal outcomes
- RRI nonresponders: higher urine output with high MAP target; no other renal parameter differed significantly (exploratory)
- Exploratory
Original publication
Renal Resistive Index Responsiveness to a Mean Arterial Pressure Test As a Guide for Mean Arterial Pressure Target in the Early Phase of Septic Shock: A Physiological Study. Crit Care Med. Published 3 August 2026. doi:10.
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