Guidelines currently recommend a mean arterial pressure (MAP) ≥65 mm Hg in septic shock, but individualized MAP targets are advocated to optimize renal outcomes.
The renal resistive index (RRI), assessed via Doppler ultrasound, reflects renal vascular resistance and is linked with acute kidney injury risk.
This prospective randomized study tested whether early RRI responsiveness to transient MAP elevation could identify patients who benefit from higher MAP targets regarding renal function.
Patients exhibiting a decrease in RRI with increased MAP did not experience improved kidney outcomes at higher MAP targets, whereas nonresponders showed increased urine output with high MAP, suggesting distinct hemodynamic-renal coupling phenotypes.
