The optimal target blood pressure in septic shock is still unknown. Therefore, in a long-term, resuscitated porcine model of fecal peritonitis-induced septic shock, Corrêa and colleagues tested whether different titrations of mean arterial pressure (50 to 60 and 75 to 85 mm Hg) would produce different effects on sepsis-related organ dysfunction. The higher blood pressure window was associated with increased needs for fluid resuscitation and norepinephrine support. However, titrating the lower blood pressure range coincided with an increased incidence of acute kidney injury. In contrast, neither the inflammatory response nor tissue mitochondrial activity showed any difference. This research paper in a clinically relevant model elegantly demonstrates that any standard resuscitation strategy may be a double-edged sword with respect to various therapeutic endpoints. Furthermore, it adds an important piece to the puzzle of the complex pathophysiology of sepsis-related acute kidney injury.
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机译：败血性休克的最佳目标血压仍然未知。因此，在长期复苏的大便性腹膜炎引起的败血性休克猪模型中，Corrêa及其同事测试了不同滴度的平均动脉压（50至60 mm Hg和75至85 mm Hg）是否会对败血症相关器官产生不同的作用功能障碍。较高的血压窗口与对液体复苏和去甲肾上腺素支持的需求增加有关。但是，在较低的血压范围内进行滴定与急性肾损伤的发生率增加有关。相反，炎症反应和组织线粒体活性均未显示任何差异。在具有临床意义的模型中的这篇研究论文优雅地证明了，就各种治疗终点而言，任何标准的复苏策略都可能是一把双刃剑。此外，它为脓毒症相关急性肾脏损伤的复杂病理生理学难题增添了重要意义。
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