Permissive Blood Pressure Targets in Pediatric Critical Care: The PRESSURE Randomized Clinical Trial.

Permissive blood pressure targets in critically ill children do not significantly reduce mortality or ventilation duration compared to usual care in the PRESSURE trial.

• Why it matters: Optimizing mean arterial pressure (MAP) in pediatric critical care is essential to improve outcomes and reduce exposure to vasoactive drugs, but current targets are uncertain.
• What they did: A multicenter randomized trial involving 1,900 children compared permissive MAP targets above the fifth percentile to usual care, measuring mortality, ventilation duration, and other clinical outcomes.
• The result: Permissive MAP targets lowered vasoactive drug use but showed no significant difference in primary outcomes; however, PICU stay was modestly shorter in survivors, indicating limited impact on major clinical endpoints.