Diastolic Blood Pressure

• The diastolic blood pressure (DBP) is determined by vascular tone and remains relativley constant throughout the arterial system.
• A low DBP (< 50 mm Hg) suggests vasodilation and may be associated with an increased risk of myocardial ischemia and left ventricular dysfunction.
• In a recent trial, Ospina-Tascon and colleagues described the diastolic shock index (heart rate/DBP) and found that a DSI > 2.2 was associated with higher mortality in patients with septic shock.
• Take Home Point: pay attention to the DBP and, when low, consider initiation of vasopressors concomitant with fluid resuscitation.

References

Hernandez G, et al. Invasive arterial pressure monitoring: much more than mean arterial pressure! Intensive Care Med. 2022. Published online ahead of print.