Alarm configuration and adherence to prescribed mean arterial pressure targets in the intensive care unit: A multicentre pre–post evaluation
1
Issued Date
2026-09-01
Resource Type
ISSN
14412772
eISSN
26529335
Scopus ID
2-s2.0-105044456119
Journal Title
Critical Care and Resuscitation
Volume
28
Issue
3
Rights Holder(s)
SCOPUS
Bibliographic Citation
Critical Care and Resuscitation Vol.28 No.3 (2026)
Suggested Citation
MacLaverty T.K., Young P.J., Neto A.S., White K.C., Caroli A., Eastwood G., Young H., Peck L., Hikasa Y., Kitisin N., Nübel J., Costa-Pinto R. Alarm configuration and adherence to prescribed mean arterial pressure targets in the intensive care unit: A multicentre pre–post evaluation. Critical Care and Resuscitation Vol.28 No.3 (2026). doi:10.1016/j.ccrj.2026.100200 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/118043
Title
Alarm configuration and adherence to prescribed mean arterial pressure targets in the intensive care unit: A multicentre pre–post evaluation
Author's Affiliation
Monash University
Charité – Universitätsmedizin Berlin
Queensland University of Technology
Siriraj Hospital
Princess Alexandra Hospital
Hospital Israelita Albert Einstein
Austin Hospital
Wellington Hospital, New Zealand
Department of Critical Care
Medical Research Institute of New Zealand
Amsterdam UMC
Charité – Universitätsmedizin Berlin
Queensland University of Technology
Siriraj Hospital
Princess Alexandra Hospital
Hospital Israelita Albert Einstein
Austin Hospital
Wellington Hospital, New Zealand
Department of Critical Care
Medical Research Institute of New Zealand
Amsterdam UMC
Corresponding Author(s)
Other Contributor(s)
Abstract
Objective To evaluate whether structured education combined with target-aligned arterial pressure alarm limits improved alignment between documented achieved and clinician-prescribed mean arterial pressure (MAP) during vasopressor therapy. Design Multicentre pre-post quality-improvement evaluation. Setting Three tertiary intensive care units in Australia and New Zealand. Participants Adult intensive care unit patients receiving continuous vasopressor infusion with invasive arterial pressure monitoring, a documented clinician-prescribed MAP target, and available MAP and alarm-limit data during 24 h of vasopressor therapy. Intervention A centre-level bundled implementation strategy comprising structured education, target-aligned arterial pressure alarm-limit configuration, and bedside implementation support, without mandating MAP targets or altering prescribing practice. Main outcome measures The primary outcome was MAP gap, defined as documented achieved MAP minus prescribed MAP at four-hourly observation points during vasopressor therapy. Secondary outcomes included alarm window configuration, inter-site variation in MAP gap, exposure to MAP <60 mmHg, and exploratory short-term clinical outcomes. Results After the intervention, alarm window width was narrower and more consistently aligned with prescribed MAP targets (median difference in width −40 mmHg, 95% confidence interval [CI]: −45 to −35). The post-intervention phase was associated with a lower documented MAP gap (median difference: −4 mmHg, 95% CI: −5.0 to −3.0; p < 0.001), reflecting reduced overshoot above target. The proportion of observations with MAP <60 mmHg did not increase. Clinical outcome data were exploratory and incompletely captured. Conclusions Structured education combined with target-aligned arterial pressure alarm limits and bedside implementation support was associated with improved alignment between documented achieved and clinician-prescribed MAP. Further evaluation should include continuous pressure-time exposure, vasopressor dose, alarm burden, and longitudinal adherence to target-aligned alarm limits.