UMEM Educational Pearls

Category: Critical Care

Title: Redefining Hypotension

Keywords: hypotension, trauma, elderly (PubMed Search)

Posted: 7/7/2008 by Mike Winters, MBA, MD (Emailed: 7/8/2008) (Updated: 5/29/2024)
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Hypotension begins at 110 mmHg?

  • Many of us use the historical SBP cut-off point of 90 mmHg or less to identify hypotension and shock
  • Importantly, there is no data to support this arbitrary value
  • Particularly in older patients, hypotension, hypoperfusion, and increased mortality may begin sooner than previously realized
  • In this study of over 80,000 patients from the National Trauma Data Bank, a SBP < 110 mmHg was found to be more clinically relevant for identifying hypotension and hypoperfusion
  • Take Home Point: strongly consider raising your threshold for identifying hypotension and initiating resuscitation, especially in the older trauma patient.


Eastridge BJ, Salinas J, McManus JG, et al. Hypotension begins at 110 mmHg: redefining hypotension with data. J Trauma 2007;63:291-9.