Intraoperative Hemodynamics: Additional Resources-Hemodynamic Instability and Intraoperative Hypotension (IOH) Infographic

Hemodynamic Instability and Intraoperative Hypotension (IOH) Infographic

Pdf Summary

Intraoperative hypotension (IOH) is a significant challenge during surgery, defined by reductions in mean arterial pressure (MAP) below 65 mm Hg for varying durations, commonly between 1 to 15 minutes. Its incidence ranges from 19.3% to 30.9%, with reductions in MAP increasing the risk of adverse postoperative outcomes, including acute kidney injury, infections, myocardial injury, cognitive dysfunction, and mortality. Several factors contribute to IOH, including myocardial depression, external pressure on the heart, vasodilation, hypovolemia, bradycardia, pre-operative and anesthetic medications, and surgical manipulation.<br /><br />Despite efforts to mitigate IOH, unintended negative outcomes can occur due to certain interventions. Recent studies emphasize improving our understanding of hemodynamic instability through heightened awareness, education on IOH's pathophysiology, early detection, and proper hemodynamic management. Strategies for addressing IOH involve identifying at-risk patients and implementing goal-directed hemodynamic therapies tailored to individual needs, focusing on maintaining stable blood pressure.<br /><br />Postoperative complications associated with IOH include acute kidney injury, surgical site infections, myocardial injury after non-cardiac surgery, pneumonia, and stroke, among others. The severity and duration of hypotension, blood pressure variability, and factors like advanced age, significantly influence these negative outcomes.<br /><br />The consensus recommendations from anesthesia professionals highlight fostering better practices to manage IOH, stressing the importance of understanding its causes, risks, and the implementation of interventions that prioritize patient safety. The goal is to reduce the incidence and severity of IOH to improve surgical outcomes and patient safety. Continuing education and leveraging consensus recommendations are crucial components in advancing clinical practices to mitigate the risks associated with IOH.

Keywords

intraoperative hypotension

mean arterial pressure

postoperative outcomes

hemodynamic instability

acute kidney injury

myocardial injury

hypotension management

surgical complications

patient safety

anesthesia recommendations