SSC MAP Target Septic Shock — FRCA Final MCQ

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EasyIntensive Care MedicineSSC MAP Target Septic ShockFRCA Final

A 65-year-old man in ICU with septic shock has a mean arterial pressure of 68 mmHg on noradrenaline. His serum lactate is 4.2 mmol/L. The Surviving Sepsis Campaign 2021 recommends targeting an initial MAP of:

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Correct answer: C — ≥65 mmHg

SSC 2021 guidelines recommend targeting an initial MAP of ≥65 mmHg during resuscitation of septic shock. This target represents a balance between ensuring adequate organ perfusion and minimising vasopressor-related adverse effects (digital ischaemia, mesenteric ischaemia, arrhythmias). The SEPSISPAM trial (2014) compared MAP 65-70 vs 80-85 mmHg and found no mortality difference overall, though patients with pre-existing hypertension may benefit from higher targets. Individualisation based on clinical response (urine output, lactate clearance, mental status) is recommended.

Reference: SSC – 2021 – International guidelines for sepsis; Asfar P et al – 2014 – SEPSISPAM trial