Acute cardiac care & resuscitationRandomised controlled trial

Permissive Blood Pressure Targets in Pediatric Critical Care

JAMAPublished

  • Randomised controlled trial
  • multicentre
  • unblinded
  • pragmatic

Authors' conclusion

Adopting a permissive MAP target resulted in no significant difference in mortality and duration of invasive ventilation at 30 days compared with usual care.

Study context

Population
Critically ill children receiving invasive ventilation and vasoactive drugs for hypotension, 23 pediatric intensive care units (PICUs) in 3 countriesprimary analysis: 910 vs 904
Participants
1,900 children
Comparison
Permissive mean arterial pressure (MAP) target vs usual care
  • Permissive MAP targetn = 957
  • Usual caren = 943reference
Primary endpoint
Composite of:
  • Mortality
  • Duration of invasive ventilation
Follow-up
30 days

Primary result

As reported in the abstract

No significant difference between the groups in the primary outcome

probabilistic index 0.52 (95% CI 0.49-0.54; P = .23)

Secondary outcomes

MAP while receiving vasoactive drugs

PICU length of stay (survivors) · significantly shorter

probabilistic index 0.53 (0.50–0.56)

Norepinephrine-equivalent total dose

Reduction in median dose with permissive MAP target vs usual care
37.5%

Other secondary outcomes (6 of 7)

Similar between the groups

Safety

Kidney replacement therapy and adverse events

Did not differ between the groups

Original publication

Permissive Blood Pressure Targets in Pediatric Critical Care. JAMA. Published 28 September 2026. doi:10.1001/jama.2026.19747

Summarised from the published abstract; every number is checked against it