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<p>In sepsis, optimizing mean arterial pressure (MAP) for organ perfusion remains challenging. We conduct a single-center, single-blind, parallel-group randomized controlled trial enrolling 274 sepsis patients to evaluate whether renal resistive index (RRI)-guided MAP titration (MAP titration group, MTG) reduces 28-day all-cause mortality (primary endpoint) compared with conventional treatment (conventional treatment group, CTG). Post-titration, RRI decreases significantly in the MTG versus CTG (0.61 vs. 0.67, <i>P</i> &lt; 0.001). However, 28-day mortality does not differ (25/138 vs. 36/136; RR 0.69, 95% CI 0.44-1.08; <i>P</i> = 0.11). These findings suggest that RRI-guided MAP titration improves renal hemodynamics but does not reduce mortality in this single-center trial; multicenter confirmation is warranted. (Chinese Clinical Trial Registry, ChiCTR2200057136, registered 1 March 2022; <a href="https://www.chictr.org.cn/showprojEN.html?proj=153154">https://www.chictr.org.cn/showprojEN.html?proj=153154</a>).</p>

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Renal resistive index-guided mean arterial pressure titration in sepsis: a prospective single-center, single-blind, parallel-group randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月17日

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  • Can Wang,
  • Rong Li,
  • Qiqi Li,
  • Meng Wang,
  • Yan Huo,
  • Yaqi Han,
  • Qian Zhang,
  • Bingqi Lu,
  • Zhenjie Hu,
  • Xiaoting Wang,
  • Yangong Chao,
  • Lixia Liu

摘要

In sepsis, optimizing mean arterial pressure (MAP) for organ perfusion remains challenging. We conduct a single-center, single-blind, parallel-group randomized controlled trial enrolling 274 sepsis patients to evaluate whether renal resistive index (RRI)-guided MAP titration (MAP titration group, MTG) reduces 28-day all-cause mortality (primary endpoint) compared with conventional treatment (conventional treatment group, CTG). Post-titration, RRI decreases significantly in the MTG versus CTG (0.61 vs. 0.67, P < 0.001). However, 28-day mortality does not differ (25/138 vs. 36/136; RR 0.69, 95% CI 0.44-1.08; P = 0.11). These findings suggest that RRI-guided MAP titration improves renal hemodynamics but does not reduce mortality in this single-center trial; multicenter confirmation is warranted. (Chinese Clinical Trial Registry, ChiCTR2200057136, registered 1 March 2022; https://www.chictr.org.cn/showprojEN.html?proj=153154).