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Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT)
BACKGROUND: Intraoperative hypotension is associated with organ injury. Current intraoperative arterial pressure management is mainly reactive. Predictive haemodynamic monitoring may help clinicians reduce intraoperative hypotension. The Acumen™ Hypotension Prediction Index software (HPI-software) (...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10430826/ https://www.ncbi.nlm.nih.gov/pubmed/37588176 http://dx.doi.org/10.1016/j.bjao.2023.100140 |
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author | Kouz, Karim Monge García, Manuel Ignacio Cerutti, Elisabetta Lisanti, Ivana Draisci, Gaetano Frassanito, Luciano Sander, Michael Ali Akbari, Amir Frey, Ulrich H. Grundmann, Carla Davina Davies, Simon James Donati, Abele Ripolles-Melchor, Javier García-López, Daniel Vojnar, Benjamin Gayat, Étienne Noll, Eric Bramlage, Peter Saugel, Bernd |
author_facet | Kouz, Karim Monge García, Manuel Ignacio Cerutti, Elisabetta Lisanti, Ivana Draisci, Gaetano Frassanito, Luciano Sander, Michael Ali Akbari, Amir Frey, Ulrich H. Grundmann, Carla Davina Davies, Simon James Donati, Abele Ripolles-Melchor, Javier García-López, Daniel Vojnar, Benjamin Gayat, Étienne Noll, Eric Bramlage, Peter Saugel, Bernd |
author_sort | Kouz, Karim |
collection | PubMed |
description | BACKGROUND: Intraoperative hypotension is associated with organ injury. Current intraoperative arterial pressure management is mainly reactive. Predictive haemodynamic monitoring may help clinicians reduce intraoperative hypotension. The Acumen™ Hypotension Prediction Index software (HPI-software) (Edwards Lifesciences, Irvine, CA, USA) was developed to predict hypotension. We built up the European multicentre, prospective, observational EU HYPROTECT Registry to describe the incidence, duration, and severity of intraoperative hypotension when using HPI-software monitoring in patients having noncardiac surgery. METHODS: We enrolled 749 patients having elective major noncardiac surgery in 12 medical centres in five European countries. Patients were monitored using the HPI-software. We quantified hypotension using the time-weighted average MAP <65 mm Hg (primary endpoint), the proportion of patients with at least one ≥1 min episode of a MAP <65 mm Hg, the number of ≥1 min episodes of a MAP <65 mm Hg, and duration patients spent below a MAP of 65 mm Hg. RESULTS: We included 702 patients in the final analysis. The median time-weighted average MAP <65 mm Hg was 0.03 (0.00–0.20) mm Hg. In addition, 285 patients (41%) had no ≥1 min episode of a MAP <65 mm Hg; 417 patients (59%) had at least one. The median number of ≥1 min episodes of a MAP <65 mm Hg was 1 (0–3). Patients spent a median of 2 (0–9) min below a MAP of 65 mm Hg. CONCLUSIONS: The median time-weighted average MAP <65 mm Hg was very low in patients in this registry. This suggests that using HPI-software monitoring may help reduce the duration and severity of intraoperative hypotension in patients having noncardiac surgery. |
format | Online Article Text |
id | pubmed-10430826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-104308262023-08-16 Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT) Kouz, Karim Monge García, Manuel Ignacio Cerutti, Elisabetta Lisanti, Ivana Draisci, Gaetano Frassanito, Luciano Sander, Michael Ali Akbari, Amir Frey, Ulrich H. Grundmann, Carla Davina Davies, Simon James Donati, Abele Ripolles-Melchor, Javier García-López, Daniel Vojnar, Benjamin Gayat, Étienne Noll, Eric Bramlage, Peter Saugel, Bernd BJA Open Original Research Article BACKGROUND: Intraoperative hypotension is associated with organ injury. Current intraoperative arterial pressure management is mainly reactive. Predictive haemodynamic monitoring may help clinicians reduce intraoperative hypotension. The Acumen™ Hypotension Prediction Index software (HPI-software) (Edwards Lifesciences, Irvine, CA, USA) was developed to predict hypotension. We built up the European multicentre, prospective, observational EU HYPROTECT Registry to describe the incidence, duration, and severity of intraoperative hypotension when using HPI-software monitoring in patients having noncardiac surgery. METHODS: We enrolled 749 patients having elective major noncardiac surgery in 12 medical centres in five European countries. Patients were monitored using the HPI-software. We quantified hypotension using the time-weighted average MAP <65 mm Hg (primary endpoint), the proportion of patients with at least one ≥1 min episode of a MAP <65 mm Hg, the number of ≥1 min episodes of a MAP <65 mm Hg, and duration patients spent below a MAP of 65 mm Hg. RESULTS: We included 702 patients in the final analysis. The median time-weighted average MAP <65 mm Hg was 0.03 (0.00–0.20) mm Hg. In addition, 285 patients (41%) had no ≥1 min episode of a MAP <65 mm Hg; 417 patients (59%) had at least one. The median number of ≥1 min episodes of a MAP <65 mm Hg was 1 (0–3). Patients spent a median of 2 (0–9) min below a MAP of 65 mm Hg. CONCLUSIONS: The median time-weighted average MAP <65 mm Hg was very low in patients in this registry. This suggests that using HPI-software monitoring may help reduce the duration and severity of intraoperative hypotension in patients having noncardiac surgery. Elsevier 2023-05-04 /pmc/articles/PMC10430826/ /pubmed/37588176 http://dx.doi.org/10.1016/j.bjao.2023.100140 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Article Kouz, Karim Monge García, Manuel Ignacio Cerutti, Elisabetta Lisanti, Ivana Draisci, Gaetano Frassanito, Luciano Sander, Michael Ali Akbari, Amir Frey, Ulrich H. Grundmann, Carla Davina Davies, Simon James Donati, Abele Ripolles-Melchor, Javier García-López, Daniel Vojnar, Benjamin Gayat, Étienne Noll, Eric Bramlage, Peter Saugel, Bernd Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT) |
title | Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT) |
title_full | Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT) |
title_fullStr | Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT) |
title_full_unstemmed | Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT) |
title_short | Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry (EU HYPROTECT) |
title_sort | intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a european multicentre prospective observational registry (eu hyprotect) |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10430826/ https://www.ncbi.nlm.nih.gov/pubmed/37588176 http://dx.doi.org/10.1016/j.bjao.2023.100140 |
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