ReviewBritish journal of anaesthesia2021
Heterogeneous impact of hypotension on organ perfusion and outcomes: a narrative review.
Review in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 3 syntheses or guidelines pooled it, 142 citations in OpenAlex.
- Impact of intravenous antihypertensive therapy on cerebral blood flow and neurocognition: a systematic review and meta-analysis.British journal of anaesthesia · 2025Pooled it
- Preoperative patient risk factors for intraoperative hypotension: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- PeriOperative Quality Initiative (POQI) international consensus statement on perioperative arterial pressure management.British journal of anaesthesia · 2024Guideline
- Hypotensive Episodes on 24-Hour Ambulatory Blood Pressure and Cognitive Function: Insights From the SPRINT Study.Hypertension (Dallas, Tex. : 1979) · 2025Trial
- Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial.BMJ (Clinical research ed.) · 2025Trial
- Effect of Intraoperative Blood Pressure Levels on Postoperative Recovery in Frail Elderly Patients: A Randomized Controlled Trial.Clinical interventions in aging · 2025Trial
- The effect of proactiveBJA open · 2024Trial
- Rapid Treatment of Acute Decompensated Heart Failure with Cardiogenic Shock in the Emergency Setting.Cardiology and cardiovascular medicine · 2026Article
- Easy DAO2 index: a novel hemodynamic risk factor for predicting mortality in surgical and critically ill patients.Korean journal of anesthesiology · 2026Observational
- Long-Term Cognitive and Functional Outcomes of Anesthesia and Surgery in Patients with Dementia.Healthcare (Basel, Switzerland) · 2026Review
- HOPFIT: A neuro-cardiovascular monitoring framework for precision sedation, anaesthesia, and resuscitation.Journal of clinical monitoring and computing · 2026Review
- Intradialytic hypotension and hemodynamic phenotypes in children following continuous renal replacement therapy initiation.Pediatric research · 2026Observational
- Article
- Refractory septic shock: our updated pragmatic approach.Journal of anesthesia, analgesia and critical care · 2026Review
- Identification of low threshold off-target activation pathways during stimulation of carotid baroreceptor afferents in swine.bioRxiv : the preprint server for biology · 2026Article
- Association between intraoperative hypotension and myocardial injury after major open abdominal surgery.Frontiers in medicine · 2026Article
- Development of a machine learning algorithm model to predict intraoperative hypotension in elderly patients undergoing thoracic and abdominal surgeries.Open medicine (Warsaw, Poland) · 2026Article
- Long-term outcomes of pseudomyxoma peritonei after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy and its relevant risk factors in China: a retrospective study.Frontiers in surgery · 2026Article
- Performance of a modified Sequential Organ Failure Assessment score in pre-hospital critical care to predict short-term mortality: a prospective, multicentre, validation cohort study.EClinicalMedicine · 2025Article
- Use of shunt-side esCCO monitoring for hemodynamic management during hemodialysis as a novel approach for early detection of hypotension: a report of two cases.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Arterial blood pressure is the driving force for organ perfusion. Although hypotension is common in acute care, there is a lack of accepted criteria for its definition. Most practitioners regard hypotension as undesirable even in situations that pose no immediate threat to life, but hypotension does not always lead to unfavourable outcomes based on experience and evidence. Thus efforts are needed to better understand the causes, consequences, and treatments of hypotension. This narrative review focuses on the heterogeneous underlying pathophysiological bases of hypotension and their impact on organ perfusion and patient outcomes. We propose the iso-pressure curve with hypotension and hypertension zones as a way to visualize changes in blood pressure. We also propose a haemodynamic pyramid and a pressure-output-resistance triangle to facilitate understanding of why hypotension can have different pathophysiological mechanisms and end-organ effects. We emphasise that hypotension does not always lead to organ hypoperfusion; to the contrary, hypotension may preserve or even increase organ perfusion depending on the relative changes in perfusion pressure and regional vascular resistance and the status of blood pressure autoregulation. Evidence from RCTs does not support the notion that a higher arterial blood pressure target always leads to improved outcomes. Management of blood pressure is not about maintaining a prespecified value, but rather involves ensuring organ perfusion without undue stress on the cardiovascular system.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.