Gastrointestinal symptoms in sepsis shock patients: diastolic arterial pressure matter

Abstract

Abstract Background & aims: Diastolic arterial pressure(DAP) plays a key role in splanchnic perfusion during the development of septic shock. In this trial, we aim to investigate the association between diastolic arterial pressure and gastrointestinal symptoms in sepsis shock patients. Methods: In this retrospective observational study, we extract data from Medical Information Mart for Intensive Care IV by Structured Query Language. Adult patients with sepsis shock were included in the study. We excluded patients with mean arterial pressure(MAP)<65mmHg. Gastrointestinal symptoms were documented every day during the first week after ICU admission. Results: In total, there were 1990 eligible patients in the cohort. During the first week in intensive care unit, three or more gastrointestinal symptoms occurred in 52.8% of the patients. Patients with DAP>=65mmHg were more likely to have a significantly lower incidence of diarrhea (P=0.000 ) and gastrointestinal bleeding(P=0.002) compared to the other two groups. The multivariable analysis also confirmed that DAP>=65mmHg was a protective factor against developing gastrointestinal symptoms(the odds ratio (OR), 0.749; 95% confidence interval (CI), 0.592-0.948; P=0.042). Conclusions：Gastrointestinal symptoms occur frequently in early ICU days, we provide indirect evidence supporting that a further DAP aim of 65mmHg would alleviate gastrointestinal symptoms in individuals with septic shock after a MAP of 65mmHg was reached. DAP should be regarded as a potentially significant hemodynamic target for gastrointestinal perfusion.