Evidence map›Paper›PMID 41423680›Full record

ArticleJournal of anesthesia, analgesia and critical care2025

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.

Amir Ali Akbari, Christian Koch, Götz Schmidt, Daniel Schmermund, Christine Langer, Fabian Edinger, Sara Marie Denn, Melanie Markmann, Michael Sander, Marit Habicher

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of anesthesia, analgesia and critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04151264 (Influence of the "Hypotension Probability Index" on the Number and Duration of Intraoperative and Postoperative Hypotension During Extended Surgical Procedures in ENT- and OM-Surgery), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT04151264 nacompletednot on this map

Influence of the "Hypotension Probability Index" on the Number and Duration of Intraoperative and Postoperative Hypotension During Extended Surgical Procedures in ENT- and OM-Surgery

TypeinterventionalSponsorUniversity of GiessenRan2020 to 2024Enrolled75ConditionsHypotension, ENT Disease, Acute Kidney Injury, AnesthesiaArmsHypotension probability index (HPI)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Amir Ali AkbariDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Christian KochDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Götz SchmidtDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Daniel SchmermundDepartment of Oral and Maxillofacial Surgery, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Christine LangerDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Fabian EdingerDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Sara Marie DennDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Melanie MarkmannDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Michael SanderDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany.
Marit HabicherDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus Liebig University of Giessen, Giessen, Germany. Marit.Habicher@chiru.med.uni-giessen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntraoperative hypotension (IOH) during non-cardiac surgery is associated with increased risk of postoperative complications, including acute kidney injury, myocardial injury, stroke, and mortality. Artificial intelligence-based predictive hemodynamic monitoring using the Hypotension Prediction Index (HPI), combined with goal-directed therapy (GDT), has been proposed to reduce IOH. However, its effectiveness in major maxillofacial and otolaryngologic surgery remains unclear. The purpose of the study was to assess whether HPI-guided management or classical GDT reduces IOH compared to standard care in patients undergoing major maxillofacial and otolaryngologic surgery.

methodsIn this randomized controlled pilot trial at a university hospital, 75 patients were allocated to one of three groups: control (n = 25), HPI-guided GDT (n = 25), or classical GDT without HPI (n = 25). In the control group, the advanced hemodynamic monitoring was blinded to the anesthesiologist. IOH was defined as mean arterial pressure (MAP) < 65 mmHg for > 1 min. Primary endpoints were the number and total duration of IOH episodes. Secondary endpoints included the time-weighted average MAP < 65 mmHg (TWA65) and postoperative complications.

resultsSeventy-four patients were analyzed. The HPI group showed significantly fewer IOH episodes (median 3.0 vs. 7.0; p = 0.02) and shorter IOH duration (7.0 min vs. 46.0 min; p < 0.01) compared to control. No significant difference was observed between the classical GDT and control groups. Secondary outcomes were comparable across all groups.

conclusionsHPI-guided hemodynamic management significantly reduces the frequency and duration of IOH in major head and neck surgery. Larger studies are needed to evaluate effects on clinical outcomes.

trial registrationThe trial was registered on clinicaltrials.gov (NCT04151264) on 14th October 2019.

Indexed as

Acute kidney injuryGoal directed therapyHypotension prediction indexIntraoperative hypotensionMajor maxillofacial–otolaryngological surgery

Identifiers

PMID41423680
PMCPMC12752006

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.