Trial reportBMC anesthesiology2025
Hypotension prediction index smart alerts and trends to improve compliance with goal-directed hemodynamic therapy: a feasibility study.
Trial report in BMC 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 NCT05957406 (Acumen HPI Smart Alerts and Smart Trends to Improve Compliance With an Intra-operative Hemodynamic Management Algorithm and Reduce Renal Injury Following Major Elective Noncardiac Surgery.), which is not on this map. Cited by 1 paper.
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.
Acumen HPI Smart Alerts and Smart Trends to Improve Compliance With an Intra-operative Hemodynamic Management Algorithm and Reduce Renal Injury Following Major Elective Noncardiac Surgery.
Who cites it
1 citing paper in PubMed.
- The Effect of Using Hypotension Prediction Index to Reduce Intraoperative Hypotension in Elective Cesarean Sections: A Randomized Controlled Trial.Medicina (Kaunas, Lithuania) · 2026Trial
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGoal-directed hemodynamic therapy (GDHT) and Hypotension Prediction Index (HPI, Edwards Lifesciences, Irvine, CA) technology are used to improve post-operative patient outcomes. Trials evaluating GDHT are frequently limited by poor algorithm compliance. The Acumen HPI Software incorporates smart trends and alerts that highlight the probable mechanism(s) of hypotension and facilitate compliance with the GDHT algorithm. We hypothesized that prompts from the Acumen HPI Smart Alerts would improve compliance to a GDHT algorithm during moderate-to-high-risk elective noncardiac surgery.
methodsThis IRB-approved, multicenter, mixed-methods, single-arm feasibility trial included adults undergoing elective, moderate-to-high-risk noncardiac surgery requiring intra-arterial blood pressure monitoring. The HPI-guided GDHT algorithm included actionable trends at HPI > 50 and automated HPI Smart Alert notifications at HPI ≥ 85, displaying the most likely hypotension mechanism(s). The primary outcome was the proportion of HPI notifications resulting in timely algorithm-concordant interventions. The sample size was estimated to achieve a true compliance rate of at least 75% with a 95% confidence level above 60%.
resultsA total of 122 subjects were included. The enrollment among centers was balanced. The overall compliance rate was 77.1% (95% CI: 74.5-79.6%). The median area under the curve, time-weighted average, and minutes of hypotension below 65 mmHg were 8.8 (0.3, 33.7) mmHg*min, 0.0 (0.0, 0.1) mmHg, and 2.9 (0.4, 8.7) minutes, respectively.
conclusionsThis study demonstrated the potential for HPI Smart Alerts to improve compliance with an intraoperative GDHT algorithm in adults undergoing moderate to high-risk non-cardiac surgery. A low burden of intra-operative hypotension was observed, suggesting potential decreases in other associated adverse outcomes. Larger-scale randomized studies are warranted.
trial registrationThis trial was retrospectively registered at ClinicalTrials.gov on 14 July 2023 (NCT05957406).
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