The optimal initial mean arterial pressure (MAP) level in terms of renal function continued to be in patients with out-of-hospital cardiac arrest (OHCA). For a study, the goal of researchers was to calculate the relation between early MAP level and serious acute kidney injury (AKI) occurrence in patients with OHCA. In 568 consecutive patients, the percent time spent below a predefined MAP threshold and the corresponding area below threshold (ABT) were evaluated from continuous MAP calculation. Both MAP-obtained differentiations were calculated for different MAP thresholds (65, 75, and 85 mmHg) and time periods (the first 6 and 12 after ICU admission). About 274 (48%) patients developed severe AKI defined as stage 3 of KDIGO. Both ABT and percent time were themselves related to severe AKI, regardless of the MAP threshold and time period considered. The highest adjusted odds ratios for developing serious AKI were obtained while minding the first 6 h period. Within the first 6 h, every 100 mmHg-h increase in ABT under MAP thresholds of 65, 75 and 85 mmHg increased severe AKI risk by 69% (OR = 1.69; 95% CI 1.26–2.26; P<0.01), 13% (OR = 1.13; 95% CI 1.07–1.20; P<0.01) and 4% (OR = 1.04; 95% CI 1.02–1.06; P<0.01), respectively. Every 10% increase in % time spent under MAP thresholds of 65, 75 and 85 mmHg increased serious AKI risk by 19% (OR = 1.19; 95% CI 1.06–1.33; P<0.01), 12% (OR = 1.12; 95% CI 1.04–1.19; P<0.01) and 8% (OR = 1.08; 95% CI 1.02–1.14; P<0.01), respectively. Both severity and time period of initial arterial hypotension after ICU admission continued to be related to serious AKI happening while considering a MAP threshold as high as 85 mmHg after OHCA.

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