Evidence map›Paper›PMID 40493027›Full record

Trial reportEuropean journal of anaesthesiology2025

Intraoperative hypotension during robotic-assisted radical prostatectomy: A randomised controlled trial comparing standard goal-directed fluid therapy with hypotension prediction index-guided goal-directed fluid therapy.

Antonella Cotoia, Antonello Discenza, Michela Rauseo, Mario Matella, Girolamo Caggianelli, Rossana Ciaramelletti, Lucia Mirabella, Gilda Cinnella

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of anaesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06535464 (Hypotension Prediction Index), which is not on this map. Cited by 4 papers.

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

NCT06535464 nacompletednot on this map

Hypotension Prediction Index (HPI) in Patients Undergoing Robotic Assisted Radical Prostatectomy

TypeinterventionalSponsorUniversity of FoggiaRan2022 to 2023Enrolled80ConditionsHypotension During SurgeryArmsHypotension Prediction Index, No Hypotension Prediction Index
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
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

8 authors.

Antonella CotoiaFrom the Department of Intensive Care, University Hospital of Foggia, Foggia, Italy (AC, AD, MR, MM, GCa, RC, LM, GCi).
Antonello Discenza
Michela Rauseo
Mario Matella
Girolamo Caggianelli
Rossana Ciaramelletti
Lucia Mirabella
Gilda Cinnella

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobot-assisted radical prostatectomy (RARP) represents the leading application of robotic surgery in the treatment for prostate cancer with faster recovery and reduced invasiveness. Maintaining stable blood pressure during RARP is crucial to avoid complications. The approach used is goal-directed therapy (GDT); however, the Hypotension Prediction Index (HPI), a machine learning algorithm that analyses arterial waveforms, may provide additional benefits.

objectiveTo evaluate the cumulative amount, frequency and duration of intraoperative hypotension episodes in patients undergoing RARP, comparing those managed with a GDT protocol guided by the HPI algorithm versus those managed without it.

designProspective randomised study.

settingSingle-centre university hospital. Recruitment from January 2022 to April 2023.

participantsEighty-two patients.

interventionsPatients undergoing RARP were randomly assigned to either a GDT protocol alone (control) or a GDT protocol guided by the HPI (HPI group). All patients received both general anaesthesia and a single-shot spinal technique. MEAN OUTCOME MEASURES: Cumulative amount of intraoperative hypotension [measured using the time-weighted average (TWA) of mean arterial pressure (MAP) below 65 mmHg]; frequency of hypotensive events; duration of hypotensive events; postoperative complications; length of stay.

resultsNo differences were observed in TWA-MAP, or in the frequency and duration of hypotensive events between the groups. Both groups maintained stable haemodynamics with minimal hypotension, and had similar fluid infusion and vasoconstrictor administration. Additionally, there were no differences in postoperative complications or length of stay.

conclusionsIn our study, HPI guidance did not reduce intraoperative hypotension during RARP. Interestingly, the control group experienced fewer hypotensive events than typically reported in the literature, likely because of the high standards of haemodynamic and anaesthesiologic management maintained across both groups.

trial registrationClinicaltrials.gov identifier: NCT06535464.

Indexed as

Fluid TherapyHypotensionIntraoperative ComplicationsProstatectomyProstatic NeoplasmsRobotic Surgical ProceduresAgedHumansMaleMiddle AgedProspective Studies

Identifiers

PMID40493027
PMCPMC12422612

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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.