Higher MAP Targets Raise Pulmonary Pressures and RV Workload Post-Arrest

This BOX substudy quantifies the pulmonary vascular and right ventricular consequences of vasopressor-driven mean arterial pressure targets in comatose out-of-hospital cardiac arrest survivors, informing how aggressively pharmacists should titrate norepinephrine after return of spontaneous circulation.

norepinephrinedopaminevasopressorsmean arterial pressureout-of-hospital cardiac arrestpost-resuscitation carepulmonary hemodynamicsright ventricular functionpulmonary artery catheterBOX trialsubstudyrandomized controlled trial Critical Care / ICU

Background Information

Higher blood pressure targets optimize circulation in cardiac arrest survivors.

Effective hemodynamic management can substantially impact outcomes in comatose out-of-hospital cardiac arrest (OHCA) survivors during critical care. Higher mean arterial pressure (MAP) targets were associated with increased pulmonary artery pressures and cardiac output, with a temporary reduction in pulmonary vascular resistance (PVR). The study informs target MAP decisions in OHCA survivors but is limited to immediate hemodynamic changes, requiring further research for long-term outcomes. Higher MAP targets post-OHCA improved pulmonary circulation and cardiac output, despite initially higher pressures.

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Authors: Hendin SK, Beske RP, Kjaergaard J, Møller JE, Schmidt H, Mølstrøm S, Schneekloth S, Meyer MAS, Obling LEW, Hassager C, Grand J

Citation: Hendin SK, Beske RP, Kjaergaard J, et al. Impact of Higher Versus Lower Blood Pressure Targets on Pulmonary Vascular Hemodynamics During Intensive Care After Out-of-Hospital Cardiac Arrest. Acta anaesthesiologica Scandinavica. 2026;70(7):e70294. doi:10.1111/aas.70294

Article Links: PubMed · Journal / DOI

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Executive Summary

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