ArticleJournal of anesthesia2026
Automated hemodynamic management system for the prevention of hypotension and cardiac output reduction during general anesthesia: preclinical experimental validation.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Automated hemodynamic resuscitation system for computer-controlled norepinephrine, vasopressin, and fluid therapy in endotoxin-induced shock: a feasibility and physiological proof-of-concept study.Intensive care medicine experimental · 2026Article
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Authors and funding
12 authors.
Funding
Abstract
purposeIntraoperative hypotension and cardiac output (CO) reduction adversely affect outcomes and require cause-specific treatment against vasodilation and/or hemorrhage. However, tight hemodynamic management increases anesthesiologists' workloads. We aimed to develop an automated hemodynamic management system that maintains arterial pressure (AP) and CO according to the causes, and to experimentally validate the system in anesthetized dogs.
methodsThe system automatically titrates norepinephrine (NE) and fluid to control systemic vascular resistance and stressed blood volume, respectively, thereby maintaining AP and CO. Experiment 1 (n = 8) examined whether the system could maintain hemodynamics during 80 min of induced hemodynamic perturbations-high-dose sodium nitroprusside infusion (vasodilation) and 30 mL/kg blood withdrawal (hemorrhage)-while monitoring CO invasively but precisely. Experiment 2 (n = 12) compared the system's hemodynamic control with manual control by eight board-certified anesthesiologists during the 80-min perturbation. To improve clinical feasibility, a minimally invasive CO monitor utilizing machine learning technology was integrated into the system.
resultsIn Experiment 1, the system significantly improved AP and CO, and reduced hypotension duration (mean AP < 65 mmHg) compared to when the system was deactivated. In Experiment 2, between the system's control and anesthesiologists' control, there were no significant differences in AP, total NE and fluid doses, and hypotension duration. The thermodilution technique confirmed that the system prevented CO from falling below the baseline level during the perturbation. Each anesthesiologist titrated the drugs approximately 40 times, whereas the system required only supervision.
conclusionThe system is potentially an attractive clinical tool to support anesthesiologists in perioperative hemodynamic management.
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