Trial reportAnesthesiology2025
Hemodynamic Management Guided by the Hypotension Prediction Index in Abdominal Surgery: A Multicenter Randomized Clinical Trial.
Trial report in Anesthesiology, 2025. 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 18 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.
The Hypotension Prediction Index Software Compared With Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery: A Prospective Randomized Controlled Trial
Who cites it
18 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- 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
- Non-drug perioperative interventions to reduce postoperative pulmonary complications after abdominal surgery: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2026Pooled it
- Hypotension prediction index in the prediction of better outcomes: a systematic review and meta-analysis.Korean journal of anesthesiology · 2026Pooled it
- Incidence and risk factors of acute kidney injury after abdominal surgery: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Comparison of the efficiency of ultrasound-guided ESPB and TAPB on postoperative analgesia: a system review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Effectiveness of hypotension prediction index software in reducing intraoperative hypotension in prolonged prone-position spine surgery: a single-center clinical trial.Journal of clinical monitoring and computing · 2025Trial
- Hypotension prediction index smart alerts and trends to improve compliance with goal-directed hemodynamic therapy: a feasibility study.BMC anesthesiology · 2025Trial
- The Predictive Paradigm in Perioperative Hemodynamic Management: The Role of Artificial Intelligence in Major Spine Surgery.Journal of clinical medicine · 2026Review
- Beyond the numbers: hypotension, algorithms, and the elusive promise of renal protection.Annals of translational medicine · 2026Article
- Predictive vs. Flow-Derived Haemodynamic Monitoring in Major Abdominal Surgery: Associations with Intraoperative Hypotension and Postoperative Outcomes.Medical sciences (Basel, Switzerland) · 2026Observational
- Intraoperative blood pressure management in noncardiac surgery: a narrative review based on current evidence.Intensive care medicine · 2026Review
- Perioperative Vasopressor Management in Noncardiac Surgical Patients.Anesthesiology · 2026Article
- Transformer-based deep learning model for real-time prediction of intraoperative hypotension using dynamic time-series vital signs: A retrospective study.PLoS medicine · 2026Article
- Artificial intelligence-based predictive hemodynamic monitoring in conjunction with goal-directed therapy reduces duration, frequency, and severity of intraoperative hypotension in major maxillofacial and otolaryngological surgery-a prospective randomized controlled pilot trial.Journal of anesthesia, analgesia and critical care · 2025Article
- Hypotension Prediction Index Software Compared with Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery: A Retrospective Study.Journal of clinical medicine · 2025Article
- Ability of the hypotension prediction index to predict hypotension in patients with septic shock in the intensive care unit.Scientific reports · 2025Article
- Blood Pressure Management Using the Hypotension Prediction Index During Paraganglioma Resection: A Case Report.Cureus · 2025Article
- AI for the hemodynamic assessment of critically ill and surgical patients: focus on clinical applications.Annals of intensive care · 2025Review
Corrections and comments
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Authors and funding
48 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative acute kidney injury (AKI) after major abdominal surgery leads to poor outcomes. The Hypotension Prediction Index (HPI; Edwards Lifesciences, USA) may aid in managing intraoperative hemodynamic instability. This study assessed whether HPI-guided therapy reduces moderate-to-severe AKI incidence in moderate- to high-risk elective abdominal surgery patients.
methodsThis multicenter randomized trial was conducted from October 2022 to February 2024 across 28 hospitals evaluating HPI-guided management compared to a wide range of real-world hemodynamic approaches. A total of 917 patients (65 yr or older or older than 18 yr with American Society of Anesthesiologists Physical Status greater than II) undergoing moderate- to high-risk elective abdominal surgery were included in the intention-to-treat analysis. HPI-guided management triggered interventions when the HPI exceeded 80, using fluids and/or vasopressors/inotropes based on hemodynamic data. The primary outcome was the incidence of moderate-to-severe AKI within the first 7 days after surgery. Secondary outcomes included overall complications, the need for renal replacement therapy, duration of hospital stay, and 30-day mortality.
resultsMedian age was 71 yr (interquartile range, 65 to 77) in the HPI group and 70 yr (interquartile range, 63 to 76) in standard care group. American Society of Anesthesiologists Physical Status III/IV was 58.3% (268 of 459) in the HPI group and 57.9% (263 of 458) in standard care group. The incidence of moderate-to-severe AKI was 6.1% (28 of 459) in the HPI group and 7.0% (32 of 458) in the standard care group (risk ratio, 0.89; 95% CI, 0.54 to 1.49; P = 0.66). Overall complications occurred in 31.9% (146 of 459) of the HPI group and 29.7% (136 of 458) of the standard care group (risk ratio, 1.08; 95% CI, 0.85 to 1.37; P = 0.52). The incidence of renal replacement therapy did not differ between groups. Median length of hospital stay was 6 days (interquartile range, 4 to 10) in both groups. The 30-day mortality was 1.1% (5 of 459) in the HPI group versus 0.9% (4 of 458) in standard care group (risk ratio, 1.35; 95% CI, 0.36 to 5.10; P = 0.66).
conclusionsHPI-guided hemodynamic therapy did not reduce the incidence of postoperative AKI or overall complications compared to standard care.
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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.