ReviewIntensive care medicine2026
Intraoperative blood pressure management in noncardiac surgery: a narrative review based on current evidence.
Review in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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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.
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Who cites it
2 citing papers in PubMed.
- Persistent Intraoperative Shock and Acute Kidney Injury After Liver Transplantation.Journal of clinical medicine · 2026Article
- Pathological triad of perioperative acute kidney injury: renal microcirculatory hypoxia, mitochondrial damage, and immuno-metabolic reprogramming.Frontiers in immunology · 2026Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeBlood pressure is closely monitored during anaesthesia, yet the optimal intraoperative target remains uncertain. This narrative review synthesizes contemporary observational and randomized evidence and explores emerging strategies for individualized haemodynamic management.
methodsWe reviewed major observational cohort studies, randomized controlled trials (RCTs), consensus statements, and recent technological developments addressing intraoperative hypotension, MAP thresholds, and strategies to prevent perioperative organ injury in adult noncardiac surgery.
resultsLarge observational datasets consistently demonstrate graded, duration-dependent associations between intraoperative MAP 60-70 mmHg and postoperative myocardial injury, acute kidney injury, and mortality . These findings have informed international recommendations to avoid MAP below 60-65 mmHg. However, contemporary multicentre RCTs enrolling more than 13,000 patients show that targeting higher or individualized MAP thresholds does not improve patient-centred outcomes compared with routine care (typically MAP ≥ 65 mmHg) . Only one small trial reported benefit with individualized systolic targets. Emerging evidence suggests that hypotension reflects heterogeneous haemodynamic endotypes (vasodilation, hypovolaemia, myocardial depression, bradycardia), potentially explaining why uniform pressure targets fail to improve outcomes. Continuous blood pressure monitoring, proactive norepinephrine infusion, predictive analytics, and closed-loop vasopressor systems reliably reduce hypotension exposure, although definitive outcome benefits remain unproven.
conclusionsObservational and randomized data are concordant: MAP ≥ 60-65 mmHg appears sufficient for most noncardiac surgical patients. Future progress will likely depend on mechanistic endotyping, integration of advanced monitoring, and precision-guided haemodynamic strategies rather than escalation of universal MAP targets alone.
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