The Exploration of Perioperative Hypotension Subtypes: a Prospective, Single Cohort, Observational Pilot Study

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2024 Jul 2

PMID 38952866

Authors

Xu Zhao

Yuanjia Zhang

Mengjia Kou

Zhongxing Wang

Qiulan He

Zhishuang Wen

Jingyuan Chen

Yiyan Song

Shihui Wu

Chanyan Huang

Wenqi Huang

Affiliations

Soon will be listed here.

Abstract

Background: Hypotension is a risk factor for postoperative complications, but evidence from randomized trials does not support that a higher blood pressure target always leads to optimized outcomes. The heterogeneity of underlying hemodynamics during hypotension may contribute to these contradictory results. Exploring the subtypes of hypotension can enable optimal management of intraoperative hypotension.

Methods: This is a prospective, observational pilot study. Patients who were ≥ 45 years old and scheduled to undergo moderate-to-high-risk noncardiac surgery were enrolled in this study. The primary objective of this pilot study was to investigate the frequency and distribution of perioperative hypotension and its subtypes (hypotension with or without cardiac output reduction). The exposure of hypotension and its subtypes in patients with and without myocardial or acute kidney injury were also explored.

Results: Sixty patients were included in the analysis. 83% (50/60) of the patients experienced perioperative hypotension. The median duration of hypotension for each patient was 8.0 [interquartile range, 3.1-23.3] minutes. Reduced cardiac output was present during 77% of the hypotension duration. Patients suffering from postoperative myocardial or acute kidney injury displayed longer duration and more extensive exposure in all hypotension subtypes. However, the percentage of different hypotension subtypes did not differ in patients with or without postoperative myocardial or acute kidney injury.

Conclusion: Perioperative hypotension was frequently accompanied by cardiac output reduction in moderate-to-high-risk noncardiac surgical patients. However, due to the pilot nature of this study, the relationship between hypotension subtypes and postoperative myocardial or acute kidney injury still needs further exploration.

Clinical Trial Registration: https://www.chictr.org.cn/showprojEN.html?proj=134260, CTR2200055929.

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