Hypotension Prediction Index for Prevention of Hypotension during Moderate- to High-risk Noncardiac Surgery A Pilot Randomized Trial

ConclusionsIn this pilot trial, index guidance did not reduce the amount of intraoperative hypotension. Half of the alerts were not followed by treatment, presumably due to short warning time, complex treatment algorithm, or clinicians ignoring the alert. In the future we plan to use a lower index alert threshold and a simpler treatment algorithm that emphasizes prompt treatment.Editor ’s PerspectiveWhat We Already Know about This TopicHypotension prediction algorithms commonly use arterial waveform features derived from arterial blood pressure monitoring. Whether they reduce the duration and severity of hypotension, especially in noncardiac surgery, is unknown.What This Article Tells Us That Is NewOf 214 noncardiac surgical patients, 105 (49%) patients randomized to management with a hypotension prediction algorithm, intraoperative hypotension was not reduced compared with controls. A lower alert threshold enabling adequate warning time and a simpler treatment algorithm that emphasizes prompt treatment after alert may help.
Source: Anesthesiology - Category: Anesthesiology Source Type: research