The occurrence of intra‐operative hypotension varies between hospitals: observational analysis of more than 147,000 anaesthesia

Taffé, Patrick; Sicard, Nadine; Pittet, Valérie; Pichard, Silvia; Burnand, Bernard

doi:10.1111/j.1399-6576.2009.02032.x

Cited by 29 publications

(28 citation statements)

References 40 publications

(63 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We also showed that BMI was lower in patients with IOH, and duration of surgery does not affect the occurrence of IOH, in contrast to other studies [7,11,13]. Thyroid surgery is considered to be low or moderate risk surgery.…”

Section: Discussioncontrasting

confidence: 47%

Risk factors for intraoperative hypotension during thyroid surgery

Kalezić

Stojanović²,

Ladjević³

et al. 2013

Med Sci Monit

View full text Add to dashboard Cite

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.

show abstract

Section: Discussioncontrasting

confidence: 47%

Risk factors for intraoperative hypotension during thyroid surgery

Kalezić

Stojanović²,

Ladjević³

et al. 2013

Med Sci Monit

View full text Add to dashboard Cite

show abstract

“…Some factors were significantly associated with postoperative mortality, including the patients’ respiratory comorbidities, postoperative cardiovascular complication, hypnotic level, anaesthetic management, type of surgery, older age; furthermore, only two studies were included in the meta‐analysis. Some studies showed that a MAP reduction more than 30% of the preoperative MAP or SBP < 90 mm Hg was associated with a higher risk of postoperative 30‐day mortality . Intra‐operative SBP < 90 mm Hg was associated with an increased risk of postoperative 1‐year mortality, but the duration of IOH were unclear.…”

Section: Discussionmentioning

confidence: 99%

Association of intra‐operative hypotension with acute kidney injury, myocardial injury and mortality in non‐cardiac surgery: A meta‐analysis

Pang

Liu

2019

Int J Clin Pract

View full text Add to dashboard Cite

Background Intra‐operative hypotension might induce poor postoperative outcomes in non‐cardiac surgery, and the relationship between the level or duration of Intra‐operative hypotension (IOH) and postoperative adverse events is still unclear. In this study, we performed a meta‐analysis to determine how IOH could affect acute kidney injury (AKI), myocardial injury and mortality in non‐cardiac surgery. Methods We searched PubMed (Medline), Embase, Springer, The Cochrane Library, Ovid and Google Scholar, and retrieved the related clinical trials on intra‐operative hypotension and prognosis in non‐cardiac surgery. Results Fifteen observational studies were included. The meta‐analysis showed that in non‐cardiac surgery, intra‐operative hypotension (mean arterial pressure [MAP]) <60 mm Hg for more than 1 minute was associated with an increased risk of postoperative acute kidney injury(AKI) [1‐5 minutes: odds ratio (OR) = 1.13, 95% CI (1.04, 1.23), I2 = 0, P = .003; 5‐10 minutes: OR = 1.18, 95% CI (1.07, 1.31), I2 = 0, P = .001; >10 minutes: OR = 1.35, 95% CI (1.1, 1.67), I2 = 52.6%, P = .004] and myocardial injury [1‐5 minutes: OR = 1.16, 95% CI (1.01, 1.33), I2 = 30.6%, P = .04; 5‐10 minutes: OR = 1.34, 95% CI (1.01, 1.77), I2 = 70.4%, P = .046; >10 minutes: OR = 1.43, 95% CI (1.18, 1.72), I2 = 39.4%, P < .0001]. Intra‐operative hypotension (MAP < 60 mm Hg) for 1‐5 minutes was not associated with postoperative 30‐day mortality [OR = 1.15, 95% CI (0.95, 1.4), I2 = 0, P = .154], but intra‐operative hypotension (MAP < 60 mm Hg) for more than 5 min was associated with an increased risk of postoperative 30‐day mortality [OR = 1.11, 95% CI (1.06, 1.17), I2 = 51.9%, P < .0001]. Conclusion Intra‐operative hypotension was associated with an increased risk of postoperative AKI, myocardial injury and 30‐day mortality in non‐cardiac surgery. Intra‐operative MAP < 60 mm Hg more than 1 minute should be avoided.

show abstract

“…Blood pressure targets during anesthesia and critical care have been defined empirically from population data , but there is wide disagreement between clinicians about what hypotension is significant . Although hypotension is common , the incidence of hypotension is highly dependent on the definition and reporting is related to the occurrence of complications . There is little evidence that moderate hypotension is harmful and a lower safe limit could not be determined except in the extreme .…”

Section: Limitations Of Standard Domain Measurementsmentioning

confidence: 99%

Near‐infrared spectroscopy: exposing the dark (venous) side of the circulation

Scott

Hoffman

2013

Pediatric Anesthesia

View full text Add to dashboard Cite

The safety of anesthesia has improved greatly in the past three decades. Standard perioperative monitoring, including pulse oximetry, has practically eliminated unrecognized arterial hypoxia as a cause for perioperative injury. However, most anesthesia-related cardiac arrests in children are now cardiovascular in origin, and standard monitoring is unable to detect many circulatory abnormalities. Near-infrared spectroscopy provides noninvasive continuous access to the venous side of regional circulations that can approximate organ-specific and global measures to facilitate the detection of circulatory abnormalities and drive goal-directed interventions to reduce end-organ ischemic injury.

show abstract

The occurrence of intra‐operative hypotension varies between hospitals: observational analysis of more than 147,000 anaesthesia

Cited by 29 publications

References 40 publications

Risk factors for intraoperative hypotension during thyroid surgery

Risk factors for intraoperative hypotension during thyroid surgery

Association of intra‐operative hypotension with acute kidney injury, myocardial injury and mortality in non‐cardiac surgery: A meta‐analysis

Near‐infrared spectroscopy: exposing the dark (venous) side of the circulation

Contact Info

Product

Resources

About