Transient Hypotension and Mortality in Sepsis

• Not surprisingly, septic ED patients with persistent hypotension despite fluid resuscitation have increased mortality.
• What about the more common scenario of septic ED patients who have a transient drop in their BP?
• Recent evidence suggests that ED patients with sepsis who have non-sustained decrease in their BP (SBP < 100 mm Hg) have a 3-fold increased risk of in-hospital mortality compared with those who maintain arterial pressure.
• Take Home Point: Any drop in BP in a septic patient, even if it responds to fluids, portends a higher mortality.  Be vigilant and aggressively resuscitate these patients.

References

Marchick MR, Kline JA, Jones AE. The significance of non-sustained hypotension in emergency department patients with sepsis. Intensive Care Med 2009 (published online 2/24/09).