A new method for monitoring critically ill patients with circulatory shock developed by researchers at Boston-based Massachusetts General Hospital may reduce risk of death and other negative outcomes, while also predicting potential length of hospital stay, according to an Aug. 7 MGH news release.
The method, developed in collaboration with investigators from Massachusetts Institute of Technology in Cambridge, may be a new tool clinicians could use to control blood pressure and monitor heart function in critically ill cardiology patients.
The new approach involves measuring the critical closing pressure, which "can provide an indication of blood vessel tone in response to disease and therapy," the release said, noting measuring this parameter in routine care has not yet been possible.
The research, published Aug. 7 in Nature Medicine, analyzed high-resolution waveform data from 5,532 cardiac patients in MGH's cardiac intensive care unit. Scientists viewed measured parameters — pulse pressure, arterial pressure and heart rate — to define the critical closing pressure.
Researchers then "defined a value called tissue perfusion pressure — calculated as the difference between average arterial blood pressure and critical closing pressure — and found that it predicted a patient's risk of death, length of hospital stay, and peak blood lactate level," the release said.
Additional studies will be conducted to allow researchers to understand how different therapies affect tissue perfusion pressure. Next steps also include a plan to design clinical trials to learn if the new method may improve healthcare outcomes and guide clinical care.