Mean arterial pressure

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In medicine, the mean arterial pressure (MAP) is an average blood pressure in an individual during a single cardiac cycle.[1]

Calculation[edit]

Total Peripheral Resistance (TPR) is represented mathematically by the formula:mean arterial pressure

R = ΔP/Q[2]

R is TPR. ΔP is the change in pressure across the systemic circulation from its beginning to its end. Q is the flow through the vasculature (equal to cardiac output)

In other words:

Total Peripheral Resistance = (Mean Arterial Pressure - Mean Venous Pressure) / Cardiac Output

Therefore, Mean arterial pressure can be determined from:[3]

where:

Estimation[edit]

While MAP can only be measured directly by invasive monitoring it can be approximately estimated using a formula in which the lower (diastolic) blood pressure is doubled and and added to the higher (systolic) blood pressure and that composite sum then is divided by 3 to estimate MAP. In patients with sepsis, the vasopressor dosage may be titrated based on estimated MAP. [4]

This is only valid at normal resting heart rates during which can be approximated using the measured systolic () and diastolics () blood pressures:[5][6][7]

or equivalently

or equivalently

or equivalently

where is the pulse pressure,

At high heart rates is more closely approximated by the arithmetic mean of systolic and diastolic pressures because of the change in shape of the arterial pressure pulse.

For a generalized formula of :

Where HR is the heart rate.[8]

Clinical significance[edit]

is considered to be the perfusion pressure seen by organs in the body.

It is believed that a that is greater than 70 mmHg is enough to sustain the organs of the average person. is normally between 65 and 110 mmHg.[9] MAP may be used similarly to Systolic blood pressure in monitoring and treating[clarification needed] for target blood pressure. Both have been shown advantageous targets for sepsis, trauma, stroke, intracranial bleed, and hypertensive emergencies.[10]

If the falls below this number for an appreciable time, vital organs will not get enough oxygen perfusion, and will become hypoxic, a condition called ischemia.

See also[edit]

References[edit]

  1. ^ Zheng L, Sun Z, Li J, et al. (July 2008). "Pulse pressure and mean arterial pressure in relation to ischemic stroke among patients with uncontrolled hypertension in rural areas of China". Stroke. 39 (7): 1932–7. doi:10.1161/STROKEAHA.107.510677. PMID 18451345. 
  2. ^ Total peripheral resistance, Wikipedia
  3. ^ Cardiovascular Physiology Concepts: Mean Arterial Pressure, Richard E. Klabunde, Ph.D
  4. ^ Calculating the mean arterial pressure (MAP) Nursing center2011-12-08
  5. ^ Physiology: 3/3ch7/s3ch7_4 - Essentials of Human Physiology
  6. ^ Cardiovascular Physiology (page 3) Archived 2006-12-11 at the Wayback Machine.
  7. ^ http://www.clinicalreview.com Physiology Review
  8. ^ Moran D, Epstein Y, Keren G, Laor A, Sherez J, Shapiro Y. "Calculation of mean arterial pressure during exercise as a function of heart rate". Appl Human Sci. 14: 293–5. doi:10.2114/ahs.14.293. PMID 8591100. 
  9. ^ impactEDnurse (May 31, 2007). "mean arterial pressure". impactednurse.com. Archived from the original on December 12, 2013. Retrieved 2013-12-12. 
  10. ^ Magder SA (2014). "The highs and lows of blood pressure: toward meaningful clinical targets in patients with shock". Crit Care Med. 42 (5): 1241–51. doi:10.1097/ccm.0000000000000324. PMID 24736333. 

External links[edit]