Evidence map›Paper›PMID 38879506›Full record

ArticlePerioperative medicine (London, England)2024

Hypotension prediction index for prevention of intraoperative hypotension in patients undergoing general anesthesia: a randomized controlled trial.

Chih-Jun Lai, Ya-Jung Cheng, Yin-Yi Han, Po-Ni Hsiao, Pei-Lin Lin, Ching-Tang Chiu, Jang-Ming Lee, Yu-Wen Tien, Kuo-Liong Chien

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Perioperative medicine (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04966364 nacompletednot on this map

Investigation of the Effect of Applying Hypotension Prediction Index Guidance for Prevention of Intraoperative Hypotension During Major Gastrointestinal Surgery: A Randomized Trial

TypeinterventionalSponsorNational Taiwan University HospitalRan2021 to 2022Enrolled60Conditionsthe Effect of Hypotension Prediction Index ApplicationArmshypotension prediction index guided, without hypotesion prediction index guided
NCT06937918 narecruitingnot on this mapstarted 2025, after this paper: background citation

Effect of Dynamic Arterial Elastance and Assisted Fluid Management Software Guided Adjustment of Vasopressor and Fluid Therapy in Septic Shock Resuscitation; A Pilot Study

TypeinterventionalSponsorMahidol UniversityRan2025 to 2028Enrolled60ConditionsCritical Illness, Fluid Over-load, Dynamic Arterial Elastance, Septic ShockArmsThe AFM and Eadyn - guided resuscitation group, The standard care for septic shock
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Observational
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Chih-Jun LaiInstitute of Epidemiology and Preventive Medicine, National Taiwan University, No. 17, Xu-Zhou Rd, Taipei, 10055, Taiwan.
Ya-Jung ChengDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Yin-Yi HanDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Po-Ni HsiaoDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Pei-Lin LinDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Ching-Tang ChiuDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Jang-Ming LeeDivision of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Yu-Wen TienDivision of General Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Kuo-Liong ChienInstitute of Epidemiology and Preventive Medicine, National Taiwan University, No. 17, Xu-Zhou Rd, Taipei, 10055, Taiwan. klchien@ntu.edu.tw.

Funding

National Taiwan University Hospital 111-N0057
6 · The paper itself

Abstract

backgroundIntraoperative hypotension is a common side effect of general anesthesia. Here we examined whether the Hypotension Prediction Index (HPI), a novel warning system, reduces the severity and duration of intraoperative hypotension during general anesthesia.

methodsThis randomized controlled trial was conducted in a tertiary referral hospital. We enrolled patients undergoing general anesthesia with invasive arterial monitoring. Patients were randomized 1:1 either to receive hemodynamic management with HPI guidance (intervention) or standard of care (control) treatment. Intraoperative hypotension treatment was initiated at HPI > 85 (intervention) or mean arterial pressure (MAP) < 65 mmHg (control). The primary outcome was hypotension severity, defined as a time-weighted average (TWA) MAP < 65 mmHg. Secondary outcomes were TWA MAP < 60 and < 55 mmHg.

resultsOf the 60 patients who completed the study, 30 were in the intervention group and 30 in the control group. The patients' median age was 62 years, and 48 of them were male. The median duration of surgery was 490 min. The median MAP before surgery presented no significant difference between the two groups. The intervention group showed significantly lower median TWA MAP < 65 mmHg than the control group (0.02 [0.003, 0.08] vs. 0.37 [0.20, 0.58], P < 0.001). Findings were similar for TWA MAP < 60 mmHg and < 55 mmHg. The median MAP during surgery was significantly higher in the intervention group than that in the control group (87.54 mmHg vs. 77.92 mmHg, P < 0.001).

conclusionsHPI guidance appears to be effective in preventing intraoperative hypotension during general anesthesia. Further investigation is needed to assess the impact of HPI on patient outcomes.

trial registrationClinicalTrials.gov (NCT04966364); 202105065RINA; Date of registration: July 19, 2021; The recruitment date of the first patient: July 22, 2021.

Indexed as

General anaesthesiaHypotension prediction indexIntraoperative hypotensionPostoperative complicationsTime-weighted average mean arterial pressure

Identifiers

PMID38879506
PMCPMC11180403

What OpenQuestion holds

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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.