Evidence map›Paper›PMID 39048785›Full record

SynthesisJournal of clinical monitoring and computing2024

Beyond the debut: unpacking six years of Hypotension Prediction Index software in intraoperative hypotension prevention - a systematic review and meta-analysis.

Myrto A Pilakouta Depaskouale, Stela A Archonta, Dimitrios M Katsaros, Nikolaos A Paidakakos, Antonia N Dimakopoulou, Paraskevi K Matsota

Registry-linked trialAbstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of clinical monitoring and computing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07510451 (The Hypotension Prediction Index Software Compared With Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery), which is not on this map. Cited by 8 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 4 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.

NCT07510451 narecruitingnot on this mapstarted 2026, after this paper: background citation

The Hypotension Prediction Index Software Compared With Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery: A Prospective Randomized Controlled Trial

TypeinterventionalSponsorPoznan University of Medical SciencesRan2026 to 2028Enrolled200ConditionsElective Endovascular Abdominal Aortic Surgery With an Expected Surgical Duration Exceeding 2 Hours, Elective Open Abdominal Aortic Surgery With an Expected Surgical Duration Exceeding 2 HoursArmsHPI guided heamodynamic monitoring, Standard Heamodynamic Managament according to APCO Monitoring
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Pooled it
  5. Trial
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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

6 authors.

Myrto A Pilakouta Depaskouale2nd Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, "Attikon" Hospital, 1 Rimini Street, Athens, 12462, Greece. myrtopde@gmail.com.ORCID 0009-0005-8765-3307
Stela A ArchontaDepartment of Anesthesiology, Athens General Hospital "Georgios Gennimatas", 154 Mesogion Avenue, Athens, 11527, Greece.
Dimitrios M KatsarosDepartment of Anesthesiology, Athens General Hospital "Georgios Gennimatas", 154 Mesogion Avenue, Athens, 11527, Greece.
Nikolaos A PaidakakosDepartment of Neurosurgery, Athens General Hospital "Georgios Gennimatas", 154 Mesogion Avenue, Athens, 11527, Greece.ORCID 0000-0002-1081-2809
Antonia N DimakopoulouDepartment of Anesthesiology, Athens General Hospital "Georgios Gennimatas", 154 Mesogion Avenue, Athens, 11527, Greece.
Paraskevi K Matsota2nd Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, "Attikon" Hospital, 1 Rimini Street, Athens, 12462, Greece.ORCID 0000-0003-0971-4483

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntraoperative hypotension (IOH) during general anesthesia is associated with higher morbidity and mortality, although randomized trials have not established a causal relation. Historically, our approach to IOH has been reactive. The Hypotension Prediction Index (HPI) is a machine learning software that predicts hypotension minutes in advance. This systematic review and meta-analysis explores whether using HPI alongside a personalized treatment protocol decreases intraoperative hypotension.

methodsA systematic search was performed in Pubmed and Scopus to retrieve articles published from January 2018 to February 2024 regarding the impact of the HPI software on reducing IOH in adult patients undergoing non-cardio/thoracic surgery. Excluded were case series, case reports, meta-analyses, systematic reviews, and studies using non-invasive arterial waveform analysis. The risk of bias was assessed by the Cochrane risk-of-bias tool (RoB 2) and the Risk Of Bias In Non-randomised Studies (ROBINS-I). A meta-analysis was undertaken solely for outcomes where sufficient data were available from the included studies.

results9 RCTs and 5 cohort studies were retrieved. The overall median differences between the HPI-guided and the control groups were - 0.21 (95% CI:-0.33, -0.09) - p < 0.001 for the Time-Weighted Average (TWA) of Mean Arterial Pressure (MAP) < 65mmHg, -3.71 (95% CI= -6.67, -0.74)-p = 0.014 for the incidence of hypotensive episodes per patient, and - 10.11 (95% CI= -15.82, -4.40)-p = 0.001 for the duration of hypotension. Notably a large amount of heterogeneity was detected among the studies.

conclusionsWhile the combination of HPI software with personalized treatment protocols may prevent intraoperative hypotension (IOH), the large heterogeneity among the studies and the lack of reliable data on its clinical significance necessitate further investigation.

Indexed as

HypotensionIntraoperative ComplicationsSoftwareAdultAnesthesia, GeneralHumansMachine LearningMonitoring, IntraoperativeRandomized Controlled Trials as TopicHPIHypotensionHypotension prediction index

Identifiers

PMID39048785

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.