UMEM Educational Pearls

Category: Critical Care

Title: Redefining Hypotension

Keywords: hypotension, trauma, elderly (PubMed Search)

Posted: 7/7/2008 by Mike Winters, MD (Emailed: 7/8/2008) (Updated: 8/11/2020)
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Hypotension begins at 110 mmHg?

  • Many of us use the historical SBP cut-off point of 90 mmHg or less to identify hypotension and shock
  • Importantly, there is no data to support this arbitrary value
  • Particularly in older patients, hypotension, hypoperfusion, and increased mortality may begin sooner than previously realized
  • In this study of over 80,000 patients from the National Trauma Data Bank, a SBP < 110 mmHg was found to be more clinically relevant for identifying hypotension and hypoperfusion
  • Take Home Point: strongly consider raising your threshold for identifying hypotension and initiating resuscitation, especially in the older trauma patient.

References

Eastridge BJ, Salinas J, McManus JG, et al. Hypotension begins at 110 mmHg: redefining hypotension with data. J Trauma 2007;63:291-9.