Acute cardiac care & resuscitation
Permissive Blood Pressure Targets in Pediatric Critical Care: The PRESSURE Randomized Clinical Trial
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
Methodological detailsmulticentre, unblinded, pragmatic
- Multicentre
- Unblinded
- Pragmatic
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: The PRESSURE Randomized Clinical Trial. JAMA. Published 28 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it