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Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches

Intraoperative hypotension (IOH) i.e., low arterial blood pressure (AP) during surgery is common in patients having non-cardiac surgery under general anaesthesia. It has a multifactorial aetiology, and is associated with major postoperative complications including acute kidney injury, myocardial inj...

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Autores principales: Kouz, Karim, Hoppe, Phillip, Briesenick, Luisa, Saugel, Bernd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017666/
https://www.ncbi.nlm.nih.gov/pubmed/32139925
http://dx.doi.org/10.4103/ija.IJA_939_19
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author Kouz, Karim
Hoppe, Phillip
Briesenick, Luisa
Saugel, Bernd
author_facet Kouz, Karim
Hoppe, Phillip
Briesenick, Luisa
Saugel, Bernd
author_sort Kouz, Karim
collection PubMed
description Intraoperative hypotension (IOH) i.e., low arterial blood pressure (AP) during surgery is common in patients having non-cardiac surgery under general anaesthesia. It has a multifactorial aetiology, and is associated with major postoperative complications including acute kidney injury, myocardial injury and death. Therefore, IOH may be a modifiable risk factor for postoperative complications. However, there is no uniform definition for IOH. IOH not only occurs during surgery but also after the induction of general anaesthesia before surgical incision. However, the optimal therapeutic approach to IOH remains elusive. There is evidence from one small randomised controlled trial that individualising AP targets may reduce the risk of postoperative organ dysfunction compared with standard care. More research is needed to define individual AP harm thresholds, to develop therapeutic strategies to treat and avoid IOH, and to integrate new technologies for continuous AP monitoring.
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spelling pubmed-70176662020-03-05 Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches Kouz, Karim Hoppe, Phillip Briesenick, Luisa Saugel, Bernd Indian J Anaesth Review Article Intraoperative hypotension (IOH) i.e., low arterial blood pressure (AP) during surgery is common in patients having non-cardiac surgery under general anaesthesia. It has a multifactorial aetiology, and is associated with major postoperative complications including acute kidney injury, myocardial injury and death. Therefore, IOH may be a modifiable risk factor for postoperative complications. However, there is no uniform definition for IOH. IOH not only occurs during surgery but also after the induction of general anaesthesia before surgical incision. However, the optimal therapeutic approach to IOH remains elusive. There is evidence from one small randomised controlled trial that individualising AP targets may reduce the risk of postoperative organ dysfunction compared with standard care. More research is needed to define individual AP harm thresholds, to develop therapeutic strategies to treat and avoid IOH, and to integrate new technologies for continuous AP monitoring. Wolters Kluwer - Medknow 2020-02 2020-02-04 /pmc/articles/PMC7017666/ /pubmed/32139925 http://dx.doi.org/10.4103/ija.IJA_939_19 Text en Copyright: © 2020 Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Kouz, Karim
Hoppe, Phillip
Briesenick, Luisa
Saugel, Bernd
Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches
title Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches
title_full Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches
title_fullStr Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches
title_full_unstemmed Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches
title_short Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches
title_sort intraoperative hypotension: pathophysiology, clinical relevance, and therapeutic approaches
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017666/
https://www.ncbi.nlm.nih.gov/pubmed/32139925
http://dx.doi.org/10.4103/ija.IJA_939_19
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