Trial reportBMC anesthesiology2023
Hypotension prediction index guided versus conventional goal directed therapy to reduce intraoperative hypotension during thoracic surgery: a randomized trial.
Trial report in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.
What it found
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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
26 citing papers in PubMed, 5 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Does Hypotension Prediction Index limit the occurrence of postoperative complications associated with intraoperative hypotension? A systematic review and model-averaged Bayesian meta-analysis of statistically sound studies.Journal of anesthesia · 2026Pooled it
- Hypotension prediction index in the prediction of better outcomes: a systematic review and meta-analysis.Korean journal of anesthesiology · 2026Pooled it
- Intraoperative hypotension prediction in cardiac and noncardiac procedures: is HPI truly worthwhile? A systematic review and meta-analysis.BMC anesthesiology · 2025Pooled it
- Artificial intelligence-assisted interventions for perioperative anesthetic management: a systematic review and meta-analysis.BMC anesthesiology · 2024Pooled it
- Predictive ability of hypotension prediction index and machine learning methods in intraoperative hypotension: a systematic review and meta-analysis.Journal of translational medicine · 2024Pooled it
- Comments on "Development and evaluation of an automated phenylephrine delivery system by lower-limit control for managing intraoperative hypotension" by Nagata et al.Journal of anesthesia · 2026Article
- Review
- Association of intraoperative hypotension and acute kidney injury in noncardiac surgery patients: a post hoc secondary analysis of the EU HYPROTECT registry.Journal of clinical monitoring and computing · 2026Article
- FloTrac-guided real-time hemodynamic management for pheochromocytoma resection in a pediatric patient: a case report.Frontiers in medicine · 2026Article
- Effect of intravenous infusion of remimazolam versus propofol on intraoperative neurophysiological monitoring stability and postoperative neurological function in patients undergoing spinal surgery.American journal of translational research · 2026Article
- Comparison of the Hypotension Prediction Index and pulse pressure variation-guided haemodynamic management for intra-operative hypotension during kidney transplant: A randomised controlled trial.Indian journal of anaesthesia · 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
- From Data to Decisions: Harnessing Multi-Agent Systems for Safer, Smarter, and More Personalized Perioperative Care.Journal of personalized medicine · 2025Review
- Comparison of Hemodynamic Management by Hypotension Prediction Index or Goal-Directed Therapy in Radical Cystectomies: A Prospective Observational Study.Journal of clinical medicine · 2025Article
- Feasibility of Hypotension Prediction Index-Guided Monitoring for Epidural Labor Analgesia: A Randomized Controlled Trial.Journal of clinical medicine · 2025Article
- Impact of FloTrac versus hypotension prediction index (HPI)-guided haemodynamic management on intraoperative hypotension in kidney transplantation: A retrospective observational study.Indian journal of anaesthesia · 2025Article
- Application of transesophageal echocardiography combined with FloTrac monitoring in cardiac valve replacement surgery.Frontiers in cardiovascular medicine · 2025Article
- Hypotension prediction index for minimising intraoperative hypotension: A systematic review and meta-analysis of randomised controlled trials.Indian journal of anaesthesia · 2024Article
- Should AI models be explainable to clinicians?Critical care (London, England) · 2024Article
- Prospective Human Validation of Artificial Intelligence Interventions in Cardiology: A Scoping Review.JACC. Advances · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIntraoperative hypotension is linked to increased incidence of perioperative adverse events such as myocardial and cerebrovascular infarction and acute kidney injury. Hypotension prediction index (HPI) is a novel machine learning guided algorithm which can predict hypotensive events using high fidelity analysis of pulse-wave contour. Goal of this trial is to determine whether use of HPI can reduce the number and duration of hypotensive events in patients undergoing major thoracic procedures.
methodsThirty four patients undergoing esophageal or lung resection were randomized into 2 groups -"machine learning algorithm" (AcumenIQ) and "conventional pulse contour analysis" (Flotrac). Analyzed variables were occurrence, severity and duration of hypotensive events (defined as a period of at least one minute of MAP below 65 mmHg), hemodynamic parameters at 9 different timepoints interesting from a hemodynamics viewpoint and laboratory (serum lactate levels, arterial blood gas) and clinical outcomes (duration of mechanical ventilation, ICU and hospital stay, occurrence of adverse events and in-hospital and 28-day mortality).
resultsPatients in the AcumenIQ group had significantly lower area below the hypotensive threshold (AUT, 2 vs 16.7 mmHg x minutes) and time-weighted AUT (TWA, 0.01 vs 0.08 mmHg). Also, there were less patients with hypotensive events and cumulative duration of hypotension in the AcumenIQ group. No significant difference between groups was found in terms of laboratory and clinical outcomes.
conclusionsHemodynamic optimization guided by machine learning algorithm leads to a significant decrease in number and duration of hypotensive events compared to traditional goal directed therapy using pulse-contour analysis hemodynamic monitoring in patients undergoing major thoracic procedures. Further, larger studies are needed to determine true clinical utility of HPI guided hemodynamic monitoring.
trial registrationDate of first registration: 14/11/2022 Registration number: 04729481-3a96-4763-a9d5-23fc45fb722d.
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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.