Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review

British Journal of Anaesthesia
E M WesselinkW A van Klei

Abstract

Intraoperative hypotension is a common side effect of general anaesthesia and might lead to inadequate organ perfusion. It is unclear to what extent hypotension during noncardiac surgery is associated with unfavourable outcomes. We conducted a systematic search in PubMed, Embase, Web of Science, and CINAHL, and classified the quality of retrieved articles according to predefined adapted STROBE and CONSORT criteria. Reported strengths of associations from high-quality studies were classified into end-organ specific injury risks, such as acute kidney injury, myocardial injury, and stroke, and overall organ injury risks for various arterial blood pressure thresholds. We present an overview of 42 articles on reported associations between various absolute and relative intraoperative hypotension definitions and their associations with postoperative adverse outcomes after noncardiac surgery. Elevated risks of end-organ injury were reported for prolonged exposure (≥10 min) to mean arterial pressures <80 mm Hg and for shorter durations <70 mm Hg. Reported risks increase with increased durations for mean arterial pressures <65-60 mm Hg or for any exposure <55-50 mm Hg. The reported associations suggest that organ injury might occur when ...Continue Reading

Citations

Dec 14, 2019·Current Opinion in Anaesthesiology·Heiko A KaiserMichael S Avidan
Dec 14, 2019·Current Opinion in Anaesthesiology·Katherine KozarekDiane Head
Jun 13, 2020·Current Opinion in Anaesthesiology·J Robert Sneyd, Ann E Rigby-Jones
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