The Awesome Nursing Tutor Explains Mean Arterial Pressure (MAP) in 30 Seconds

"What is mean arterial pressure (MAP)? Why is MAP so important to monitor in hemodynamically unstable clients? Watch Dan Clinton, RN, BSN, The Awesome Nursing Tutor, try to explain in 30 seconds. #nclex #nclexprep #nursing

A sample calculation:
Blood pressure of 124/78 mmHg
MAP = 124 + (2 x 78) / 3
MAP = 124 + 156 / 3
MAP = 280 / 3
MAP = 93 mmHg (rounded to the nearest whole number)

NCLEX testable points:
- MAP of at least 65 mmHg is needed for optimal perfusion
- IV fluids and vasopressors are titrated to maintain a MAP of at least 65 mmHg for clients in shock
- The goal when treating hypertensive encephalopathy is to lower the MAP 20 - 25% in the first hour

The ideal MAP for critically ill patients remains unknown. Intensivists and nephrologists continue to research the optimal MAP target for critically ill clients, but there is broad consensus to target a MAP of at least 65 mmHg

MAP less than 70 mmHg = Decreased renal perfusion
MAP less than 65 mmHg = Suboptimal renal perfusion. Significant risk of pre-renal acute kidney injury
MAP less than 60 mmHg = Inadequate perfusion to vital organs. Cellular hypoxia. Ischemia and infarction

It should also be noted that MAP, although a very good marker of perfusion, doesn't tell the whole story. During an acutely stressful event, like surgery or shock, clients can shunt blood flow away from the kidneys to the vital organs. The client may maintain a MAP higher than 70 mmHg yet develop pre-renal acute kidney injury because renal blood flow was inadequate despite a MAP within the lower limits of normal

For more information on pre-renal acute kidney injury I suggest:
"Low-Flow Acute Kidney Injury." Bruce A. Molitoris. CJASN July 2022, 17 (7) 1039-1049
Free Full text:
https://cjasn.asnjournals.org/content/clinjasn/17/7/1039.full.pdf

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