Mean arterial pressure

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The mean arterial pressure (MAP) is a term used in medicine to describe an average blood pressure in an individual.[1] It is defined as the average arterial pressure during a single cardiac cycle.

Calculation

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

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]

MAP = (CO \cdot SVR) + CVP

where:

Estimation

At normal resting heart rates MAP can be approximated using the more easily measured systolic and diastolic pressures, SP and DP:[4][5][6]

MAP \simeq DP + \frac{1}{3}(SP - DP)

or equivalently

MAP \simeq \frac{2}{3}(DP) + \frac{1}{3}(SP)

or equivalently

MAP \simeq \frac{(2 \times DP) + SP}{3}

or equivalently

MAP \simeq DP + \frac{1}{3}PP

where PP is the pulse pressure, SP-DP

At high heart rates MAP 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 MAP:

MAP \simeq DP + 0.01 \times exp(4.14 - 40.74 / HR) (SP - DP)

Where HR is the heart rate[7]

Clinical significance

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

It is believed that a MAP that is greater than 60 mmHg is enough to sustain the organs of the average person. MAP is normally between 65 and 110 mmHg.[8] MAP may be used similarly to Systolic blood pressure in[clarification needed] for target blood pressure. Both have been shown advantageous targets for sepsis, trauma, stroke, intracranial bleed, and hypertensive emergencies.[9]

If the MAP 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

References

  1. Lua error in package.lua at line 80: module 'strict' not found.
  2. Total peripheral resistance, Wikipedia
  3. Cardiovascular Physiology Concepts: Mean Arterial Pressure, Richard E. Klabunde, Ph.D
  4. Physiology: 3/3ch7/s3ch7_4 - Essentials of Human Physiology
  5. Cardiovascular Physiology (page 3)
  6. http://www.clinicalreview.com Physiology Review
  7. Calculation of mean arterial pressure during exercise as a function of heart rate.
  8. Lua error in package.lua at line 80: module 'strict' not found.
  9. Lua error in package.lua at line 80: module 'strict' not found.

External links

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it:Pressione arteriosa differenziale