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October 19, 2023BJA OpenOpen Access

Hypotension Prediction Index software alarms during major noncardiac surgery: a post hoc secondary analysis of the EU-HYPROTECT registry

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Why the study?

It was unclear to what extent Hypotension Prediction Index software monitoring contributed to limiting intraoperative hypotension in the EU-HYPROTECT registry.

Population

702 patients undergoing elective major noncardiac surgery across 12 medical centres in 5 European countries

Design

Post hoc secondary analysis of a prospective multicentre observational registry

Authors

KKKarim KouzTSThomas ScheerenTBTim van den Boom

Discussion

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Member takes

Overview

HPI alarms occur frequently at MAP ~71 mm Hg; leaves open whether alarm-guided interventions reduce hypotension-related harm.

Structured PICO

P
Population
702 patients undergoing elective major noncardiac surgery monitored using the Acumen Hypotension Prediction Index software (HPI-software) in 12 medical centres across 5 European countries.
I
Intervention
Acumen Hypotension Prediction Index software (HPI-software) monitoring using Acumen IQ sensor and HemoSphere platform
O
Outcome
Frequency, timing, and mean arterial pressure (MAP) at which HPI alarms occurred during surgery

During major noncardiac surgery, HPI alarms occurred frequently (in 89% of patients) and at a median MAP of 71 mm Hg, suggesting patients were prone to intraoperative hypotension, though the exact clinical response to these alarms remains unclear.

Limitations

  • Observational nature makes it difficult to know to what extent HPI-software monitoring contributed to limiting hypotension
  • Cannot match HPI alarms with therapeutic interventions as interventions were not systematically recorded

Cite This Study

Kouz et al. (2023) studied this question.

synapsesocial.com/papers/6a7e45d2196d67da7483e2c9https://doi.org/10.1016/j.bjao.2023.100232
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Selection Bias in the Hypotension Prediction Index: Comment2023 · 7 citations
  2. 2Shedding Needed Light on a Black Box Approach to Prediction of Hypotension2024 · 11 citations
  3. 3Hypotension Prediction Index Revalidation: Comment2025 · 2 citations
  4. 4Prediction of Hypotension: Comment2025 · 1 citations
  5. 5AcumenTM hypotension prediction index guidance for prevention and treatment of hypotension in noncardiac surgery: a prospective, single-arm, multicenter trial2024 · 6 citations