Monitoring, management, and outcome of hypotension in Intensive Care Unit patients, an international survey of the European Society of Intensive Care Medicine

Hypotension in the ICU is common, yet management is challenging and variable. Insight in management by ICU physicians and nurses may improve patient care and guide future hypotension treatment trials and guidelines. We conducted an international survey among ICU personnel to provide insight in monitoring, management, and perceived consequences of hypotension. Out of 1464 respondents, 1197 (81.7%) were included (928 physicians (77.5%) and 269 nurses (22.5%)). The majority indicated that hypotension is underdiagnosed (55.4%) and largely preventable (58.8%). Nurses are primarily in charge of monitoring changes in blood pressure, physicians are in charge of hypotension treatment. Balanced crystalloids, dobutamine, norepinephrine, and Trendelenburg position were the most frequently reported fluid, inotrope, vasopressor, and positional maneuver used to treat hypotension. Reported complications believed to be related to hypotension were AKI and myocardial injury. Most ICUs do not have a specific hypotension treatment guideline or protocol (70.6%), but the majority would like to have one in the future (58.1%). Both physicians and nurses report that hypotension in ICU patients is underdiagnosed, preventable, and believe that hypotension influences morbidity. Hypotension management is generally not protocolized, but the majority of respondents would like to have a specific hypotension management protocol. •According to the majority of ICU physicians and nurses, hypotensive events are underdiagnosed and preventable.•Nurses are in charge of monitoring changes in blood pressure, whereas physicians are in charge of treating hypotension.•Most respondents indicated that hypotension management should be improved in their ICU.•Frequently reported complications believed to be related to hypotension were acute kidney injury and myocardial injury.•Most ICUs do not have a hypotension treatment protocol, but the majority of the respondents would like to have one.