Permissive blood pressure targets did not improve outcomes in critically ill children

The PRESSURE trial randomized 1900 critically ill children receiving invasive ventilation and vasoactive drugs for hypotension across 23 PICUs to either a permissive mean arterial pressure target (above the fifth percentile for age) or usual care with physician-set targets. The permissive target group received a 37.5% lower median norepinephrine-equivalent dose, but the trial reported no significant difference in the composite primary outcome of mortality and duration of invasive ventilation at 30 days; PICU length of stay among survivors was shorter in the permissive group, while other secondary outcomes, including kidney replacement therapy and adverse events, did not differ.

Most relevant for: Critically ill children in pediatric intensive care units receiving invasive ventilation and vasoactive drugs for hypotension.

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