Intraoperative hypotension: Killing them softly-Slide Deck - Intraoperative hypotension: Killing them softly

Slide Deck - Intraoperative hypotension: Killing them softly

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The document "Intraoperative Hypotension: Killing Them Softly" by Amy D. Yerdon and Desiree L. Chappell delves into the significant concerns surrounding intraoperative hypotension (IOH) and its impact on patient outcomes during surgery. It highlights the correlation between the incidence of IOH and negative patient health outcomes, emphasizing the importance of evidence-based strategies to manage and prevent IOH.<br /><br />Intraoperative hypotension is generally defined by a mean arterial pressure (MAP) of less than 65 mmHg, with studies revealing an increased risk of complications at this threshold. The document underscores the fact that both the duration and depth of IOH contribute to patient harm, referencing various studies that link IOH with adverse postoperative outcomes like acute kidney injury (AKI) and the progression of chronic kidney disease.<br /><br />A multicenter observational analysis cited in the document indicates that IOH is common in community anesthesia practices and varies widely across clinicians. With significant variations noted even after adjusting for risks, the text suggests that IOH may be partially determined by the provider's tolerance levels, indicating a potential area for quality improvement.<br /><br />Preventive strategies and management techniques discussed include the use of goal-directed hemodynamic therapy, continuous finger-cuff pressure monitoring, and the strategic use of fluids and vasopressors. The document also calls for balancing circulation and maintaining hemodynamic stability without causing further harm.<br /><br />The authors discuss new research and advancements in monitoring technology, including AI, as potential tools to address IOH effectively. Overall, the document calls for improved intervention strategies and better-established guidelines to mitigate the risks associated with IOH, thereby improving patient safety and outcomes post-surgery.

Keywords

intraoperative hypotension

patient outcomes

mean arterial pressure

acute kidney injury

chronic kidney disease

goal-directed therapy

hemodynamic stability

vasopressors

monitoring technology

AI in anesthesia