Renal resistive index-guided mean arterial pressure titration in sepsis: a prospective single-center, single-blind, parallel-group randomized controlled trial.
rct · Level II
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- Record sourced from PubMed, PMID 42469213.
- Also identified by DOI 10.1038/s41467-026-75398-7.
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Abstract
In sepsis, optimizing mean arterial pressure (MAP) for organ perfusion remains challenging. We conduct a single-center, single-blind, parallel-group randomized controlled trial enrolling 274 sepsis patients to evaluate whether renal resistive index (RRI)-guided MAP titration (MAP titration group, MTG) reduces 28-day all-cause mortality (primary endpoint) compared with conventional treatment (conventional treatment group, CTG). Post-titration, RRI decreases significantly in the MTG versus CTG (0.61 vs. 0.67, P < 0.001). However, 28-day mortality does not differ (25/138 vs. 36/136; RR 0.69, 95% CI 0.44-1.08; P = 0.11). These findings suggest that RRI-guided MAP titration improves renal hemodynamics but does not reduce mortality in this single-center trial; multicenter confirmation is warranted. (Chinese Clinical Trial Registry, ChiCTR2200057136, registered 1 March 2022; https://www.chictr.org.cn/showprojEN.html?proj=153154).