The following is a summary of “Early persistent exposure to high CVP is associated with increased mortality and AKI in septic shock: A retrospective study,” published in the December 2023 issue of Emergency Medicine by Xiao, et al.

For a study, researchers sought to explore the correlation between exposure to varying levels of central venous pressure (CVP) over time in septic shock patients with 28-day mortality and acute kidney injury (AKI).

Data from the AmsterdamUMCdb were analyzed, encompassing patients aged ≥18 with septic shock who underwent CVP monitoring. The primary endpoint was mortality by day 28. Piecewise exponential additive mixed models were employed to assess the association over time.

The study comprised 9,668 patients, with an overall 28-day mortality of 8.2% and an AKI incidence of 41.1%. The daily time-weighted average CVP demonstrated a robust association with increased 28-day mortality, particularly within the first 24 hours of ICU admission. Patients exhibited the lowest mortality rate when CVP ranged from 6 to 12 cmH₂O. Exposure to high CVP (>12 cmH₂O) for over 5 hours within the initial 24 hours was associated with a 2.69-fold increase in the risk of death. Moreover, patients exposed to high CVP were significantly more prone to developing AKI.

For patients with septic shock within the first 24 hours of ICU admission, the optimal CVP range appears to be 6–12 cmH₂O. Mortality risk escalates with prolonged exposure to high CVP (>5 hours).

Reference: sciencedirect.com/science/article/pii/S0735675723005168