For a study, researchers sought to investigate whether patients in septic shock would react differently to a low-MAP target (65 to 70 mmHg) versus a high-MAP target (80 to 85 mmHg). Every 2 hours starting 2 hours after insertion and continuing until catecholamine withdrawal, the presence of mottling was evaluated. Between the 2 MAP target groups contrasted the mottling and lactate time courses. Based on whether there was mottling or not, they assessed the patient’s outcome. There were 747 patients; 374 had low MAP levels, and 373 had high MAP levels. Both lactate production and mottling did not differ between the 2 MAP groups over the first 24 hours. It was revealed that mottling lasting longer or around 6 hours during the first 24 hours was substantially associated with an elevated risk of death on days 28 and 90 after adjusting for MAP and confounding variables. Patients who had mottling for less than 6 hours or whose lactate levels were higher than 2 mmol/L had a higher chance of surviving than patients whose mottling lasted longer than 6 hours or whose lactate levels were lower or around 2 mmol/L. A greater MAP objective had no impact on mottling or lactate course compared to a low MAP aim. Mortality rates were higher when the molting process lasted longer or around 6 hours. The duration of the mottling appears to be a more accurate predictor of death than arterial lactate.
Source:
annalsofintensivecare.springeropen.com/articles/10.1186/s13613-022-01053-1
