Heterogeneous cardiovascular responses to acute mean arterial pressure augmentation in septic shock : the role of ventriculo-arterial coupling and venous return
Acute MAP augmentation elicited markedly heterogeneous cardiovascular responses in patients with septic shock despite comparable increases in arterial pressure. Flow deterioration is characterized by worsening ventriculo-arterial coupling, reduced stroke volume, and insufficient systolic adaptation, potentially compounded by unfavorable changes in venous return determinants. These findings suggest that MAP augmentation may be viewed not only as a pressure-targeting intervention but also as a dynamic cardiovascular stress test, revealing the integrated ability of the circulation to adapt to acute vascular loading conditions. Whether this response can help individualize MAP targets and vasopressor therapy warrants further prospective evaluation.
