The following is the summary of “Increased mean perfusion pressure variability is associated with subsequent deterioration of renal function in critically ill patients with central venous pressure monitoring: a retrospective observational study” published in the November 2022 issue of Renal failure by  Peng, et al.

Recently, the mean perfusion pressure (MPP) has been proposed for use in the individualized management of tissue perfusion pressure in critically ill patients. Organ damage may be linked to increased MPP variability (MPPV). Their aim was to learn if higher MPPV levels preceded declines in renal function in the critically unwell. Researchers looked into information from the MIMIC-IV and eICU-CRD databases. The exposure was MPPV, and it was quantified using the coefficient of variation (CV) of the MPP data from the first 24 hours following the initial admission to the intensive care unit. 

Renal function decline, as measured by the development or worsening of acute kidney damage within the first 72 hours of intensive care unit admission, was the primary outcome. 8,590 patients from the eICU-CRD database and 6,723 patients from the MIMIC-IV database made up the study population. Renal function declined by 28.4% and 30.2%, respectively, among the entire study population. The median MPP-CV was higher in patients with declining renal function (12.2% vs 11.5% and 12.8% vs 12.5%, P<.001). An increased MPP-CV was linked with an increased risk of the primary endpoint in fully adjusted multivariate logistic models (adjusted OR per 1-SD, 1.08; 95% CI, 1.02-1.13 and adjusted OR per 1-SD, 1.06; 95% CI, 1.00-1.12, respectively). 

Those who underwent cardiac surgery, medical sepsis, and other procedures exhibited heterogeneity in pooled studies. When monitoring vital signs using a central venous pressure monitor, patients in critical care found that an increase in mean pulmonary artery pressure variability (MPPV) was associated with an increased risk of eventual decline in renal function. The risk of renal function decline may be mitigated by keeping MPP constant.