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1-1 of 1 results by Scott Sparks


Title: Renal Resistive Index-Guided MAP titration in Sepsis

Category: Critical Care Literature Update

Keywords: Renal Resistive Index, Sepsis, MAP, Ultrasound (PubMed Search)

Posted: 9/8/2026 by Scott Sparks, MD (Updated: 9/17/2026)

Reducing 28-day all-cause mortality compared to conventional MAP management in sepsis patients requiring vasopressors after initial resuscitation.

  • Cardiac output, MAP, and organ-specific vascular resistance determine organ perfusion.
  • SEPSISPAM trial showed that a higher MAP reduced need for renal replacement therapy.
  • An elevated Renal Resistive-Index (RRI) > 0.7 is associated with impaired perfusion, development of AKI, and increased MR.
  • The kidney is a low vascular resistance organ sensitive to hypoperfusion in sepsis. 
  • 28-day all-cause MR and ventilator free days was decreased. 
  • RRI-guided MAP titration did not specifically decrease MR, incidence of AKI or need for CRRT.
  • Although a pilot trial, this study lends credence to more individualized sepsis hemodynamic management and the need for a larger study.
  • Use of RRI-guided MAP titration in sepsis may decrease overall 28-day MR.
  • How to Guide. https://ultrasoundpaedia.com/renal-arteries-normal/

Show References

Wang C, et al. Renal resistive index-guided mean arterial pressure titration in sepsis: a prospective single-center, single-blind, parallel group randomized controlled trial. Nature Communications. 2026; 17:8759.



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