Objective      To study the correlation between the mean arterial

pressure (MAP) and incidence of acute kidney injury (AKI) as well as prognosis in the patients with septic shock in intensive care unit (ICU).       Methods      Retrospective clinical data review of 79 patients with septic shock (53 males and 26 females) at the age of 62.4±10.1 years admitted to our ICU from June 2013 to December 2015 was performed. Normal MAP level of the patients (MAP

n

) was calculated by the normal blood pressure data. Following the early goal-directed therapy (EGDT) all patients were treated with adequate fluid resuscitation and given norepinephrine to maintain a MAP (MAP

k

). These patients were divided into 3 groups: group A (MAP

k

＜75% MAP

n

n=45)

group B (75% MAP

n

≤MAP

k

＜90%MAP

n

n=23)

and group C (90% MAP

n

≤MAP

k

＜MAP

n

n=11). The cardiac index (CI)

systemic vascular resistance index (SVRI)

MAP

central venous pressure (CVP)

oxygen metabolism [DO

2

VO

2

and oxygen extraction ratio (O

2

ER)

]

blood lactic acid

urinary output

and serum creatinine were compared among the groups before treatment and at 6

12

24

48 and 72 h after treatment. The lactic acid clearance (6 and 12 h)

occurrence of serious cardiac events (arterial fibrillation

ventricular fibrillation/tachycardia and acute myocardial infarction)

incidence of AKI

and 28-day survival rate were also observed.       Results      During the treatment

the MAP

CI and SVRI of 3 groups have no significant differences. After 6

24

48

72 hours’ treatment

the CVP in group B were significantly lower than group A (P0.05). There was no significant difference in DO

2

or VO

2

among the 3 groups. The O

2

ER values at 12

24

48 h after treatment were higher in group B than group A (P0.05). In comparison of groups B and C to group A

blood lactic acid after 6

12

24 hours’ treatment and serum creatinine were significantly lower

whereas lactate clearance rate after 6 and 12

hours’ treatment and urinary output after 12

24 and 48 hours’ treatment were significantly higher (P0.05). Additionally

the occurrence of serious cardiac events did not differ significantly among the groups. Within 72 h 27

6 and 5 cases of AKI were occurred in group A

B and C respectively. The incidence rate was lower in group B (6/23) than group A (27/45) though without statistical significance (P=0.011). The 28-day survival rates for group A

B and C were 63.95%

73.91% and 63.64% respectively

which were not significant different (P0.05).       Conclusion      It is very likely that maintenance of MAP nearly to normal level is beneficial to prevent the occurrence of AKI and serious cardiac events in patients with septic shock in ICU.