Risk of Intraoperative Hypotension with Loop Diuretics: A Randomized Controlled Trial

Khan, Nadia; Campbell, Norman R.C.; Frost, Shaun D.; Gilbert, Ken; Michota, Frank; Usmani, Ali; Seal, Douglas; Ghali, William A.

doi:10.1016/j.amjmed.2010.07.019

Cited by 29 publications

(16 citation statements)

References 21 publications

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“…However, Reich [14] demonstrated that ACE inhibitors or other antihypertensive therapy did not affect occurrence of IOH. It was also shown that preoperative administration of furosemide, including on the day of surgery, does not affect the occurrence of IOH [20]. As recommended by cardiologists, we excluded ACE inhibitors 24 hr before surgery because of the possible influence on intra-and postoperative hypotension, while all other antihypertensive drugs were used regularly, including on the day of surgery.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for intraoperative hypotension during thyroid surgery

Kalezić

Stojanović²,

Ladjević³

et al. 2013

Med Sci Monit

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BackgroundHypotension is a common adverse effect of IV anaesthetics, especially during the induction of anaesthesia. The aim of our study was to determine the incidence and risk factors for intraoperative hypotension (IOH) in thyroid surgery, as well as to determine whether and to what extent IOH affects the occurrence of postoperative hypotension.Material/MethodsThe study included 1252 euthyroid patients, ASA 2 and ASA 3 status (American Society of Anesthesiologists physical status classification), who had thyroid surgery between 2007 and 2011. IOH was defined as a decrease in systolic blood pressure of >20% of baseline values. We studied the influence of demographic characteristics (sex, age, body mass index-BMI), comorbidity, type and duration of surgery, and anaesthesia on the occurrence of IOH. Univariate and multivariate logistic regression were used to determine predictors of occurrence of IOH.ResultsIOH was registered in 6.5% of patients. The most common operation was thyroidectomy. Patients with IOH were younger, had lower BMI, and significantly less often had hypertension as a coexisting disease. The multivariate regression model identified BMI and the absence of hypertension as a coexisting disease, and as independent predictors of occurrence of IOH. Significantly more patients with IOH had postoperative hypotension (9.9% vs. 2.4%, p=0.000).ConclusionsIOH is common, even during operations of short duration and with minimal bleeding. It is necessary to pay special attention to these patients, given that many of these patients remained hypotensive during the postoperative period.

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Section: Discussionmentioning

confidence: 99%

Risk factors for intraoperative hypotension during thyroid surgery

Kalezić

Stojanović²,

Ladjević³

et al. 2013

Med Sci Monit

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“…Second, there is a potential for selection bias, given that these patients were previously studied for their risk for intraoperative hypotension with loop diuretics. 11 In our previous trial, furosemide was not associated with intraoperative hypotension. However, it is possible that the clinical indications for furosemide therapy may have skewed the population towards intraoperative hypotension.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 97%

“…Further details regarding patient recruitment and data collection are published elsewhere. 11 Data on preoperative patient characteristics and intraoperative hemodynamic measurements were collected. Baseline data included blood pressure, heart rate, weight, concomitant medication history, any recommended medication changes, type of surgery and preoperative cardiac risk severity score based on the Revised Cardiac Risk Index (RCRI).…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…A trained research assistant collected data on the operative blood pressure readings, heart rate readings and development of clinical events. 11 Variables selected for entry into the model were based on the bivariate analysis, biological plausibility, and a literature review of known associated factors. These factors included: age, sex, preoperative hemodynamic parameters, comorbid conditions, RCRI, surgery type and preoperative medications.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

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Predictors of Intraoperative Hypotension and Bradycardia

Cheung¹,

Martýn²,

Campbell³

et al. 2015

The American Journal of Medicine

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“…Continuation or stopping of loop diuretics should be considered on a per-patient basis; definitive data that these drugs are harmful are lacking. 50…”

Section: Recommendations For Practicementioning

confidence: 99%

Perioperative Quality Initiative consensus statement on preoperative blood pressure, risk and outcomes for elective surgery

Sanders

Hughes

Shaw

et al. 2019

British Journal of Anaesthesia

153

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Background: A multidisciplinary international working subgroup of the third Perioperative Quality Initiative consensus meeting appraised the evidence on the influence of preoperative arterial blood pressure and community cardiovascular medications on perioperative risk. Methods: A modified Delphi technique was used, evaluating papers published in MEDLINE on associations between preoperative numerical arterial pressure values or cardiovascular medications and perioperative outcomes. The strength of the recommendations was graded by National Institute for Health and Care Excellence guidelines.

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Risk of Intraoperative Hypotension with Loop Diuretics: A Randomized Controlled Trial

Cited by 29 publications

References 21 publications

Risk factors for intraoperative hypotension during thyroid surgery

Risk factors for intraoperative hypotension during thyroid surgery

Predictors of Intraoperative Hypotension and Bradycardia

Perioperative Quality Initiative consensus statement on preoperative blood pressure, risk and outcomes for elective surgery

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