Correspondence  |   October 2017
In Reply
Author Notes
  • Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio (D.I.S.). DS@OR.org
  • (Accepted for publication June 30, 2017.)
    (Accepted for publication June 30, 2017.)×
Article Information
Correspondence
Correspondence   |   October 2017
In Reply
Anesthesiology 10 2017, Vol.127, 726-728. doi:10.1097/ALN.0000000000001811
Anesthesiology 10 2017, Vol.127, 726-728. doi:10.1097/ALN.0000000000001811
Nothing in our article1  suggests that some patients cannot safely be maintained at intraoperative mean arterial pressures less than 65 mmHg. For example, some patients come to surgery with pressures at about that level and will presumably tolerate at least somewhat lower ones. Similarly, some patients may require higher pressures—presumably those with conditions that restrict organ perfusion. Importantly, the article to which Saugel and colleagues refer evaluated myocardial injury and acute kidney injury; we have previously reported associations between mean arterial pressure and 30-day all-cause mortality, and the thresholds are somewhat higher.2  Harm thresholds for other organs might differ.
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