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July 29, 2021Acta Anaesthesiologica ScandinavicaOpen Access

HPI guidance resulted in a significantly lower incidence of hypotension (52% vs 84%, p=0.001) and lower median time-weighted average of hypotension (0.10 mmHg vs 0.27 mmHg, p=0.001) compared to FloTrac.

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Why the study?

Intraoperative hypotension increases morbidity and mortality, but whether the Hypotension Prediction Index with a personalized protocol reduces intraoperative hypotension compared with arterial waveform analysis alone remained to be tested.

Does Hypotension Prediction Index (HPI) guidance reduce the incidence and duration of intraoperative hypotension in adults undergoing moderate- or high-risk noncardiac surgery?

Population

100 consecutive adult patients undergoing moderate- or high-risk noncardiac surgery with invasive arterial pressure monitoring

Comparison

Hypotension Prediction Index guidance vs arterial waveform analysis (FloTrac)

Design

Retrospective analysis

Authors

CGCarla D. GrundmannJWJan M. WischermannPFPhilipp Faßbender

Discussion

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Overview

HPI with personalized protocol was associated with less hypotension; leaves open prospective confirmation before adoption.

Structured PICO

Does Hypotension Prediction Index (HPI) guidance reduce the incidence and duration of intraoperative hypotension in adults undergoing moderate- or high-risk noncardiac surgery?

P
Population
100 adult consecutive patients undergoing moderate- or high-risk noncardiac surgery with invasive arterial pressure monitoring
I
Intervention
Hypotension Prediction Index (HPI) guidance combined with a personalized treatment protocol
C
Comparator
Arterial waveform analysis alone (FloTrac) combined with a personalized treatment protocol
O
Outcome
Incidence and duration of hypotensive events defined as MAP <65 mmHg evaluated by time-weighted average of hypotensionsurrogate

The use of the Hypotension Prediction Index combined with a personalized treatment protocol significantly reduces the incidence and duration of intraoperative hypotension compared to standard arterial waveform analysis.

Cite This Study

Grundmann et al. (2021) studied this question.

synapsesocial.com/papers/6a7e45d4196d67da7483e2cbhttps://doi.org/10.1111/aas.13964
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Also Consider

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

  1. 1The Incidence of Perioperative Hypotension in Patients Undergoing Major Abdominal Surgery with the Use of Arterial Waveform Analysis and the Hypotension Prediction Index Hemodynamic Monitoring—A Retrospective Analysis2024 · 9 citations
  2. 2Hypotension Prediction Index and Incidence of Perioperative Hypotension: A Single-Center Propensity-Score-Matched Analysis2023 · 14 citations
  3. 3Hypotension Prediction Index Software Compared with Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery: A Retrospective Study2025
  4. 4Hypotension prediction index in surgical patients: A systematic review and meta-analysis of randomized controlled trials2026 · 1 citations
  5. 5Intraoperative hypotension prediction in cardiac and noncardiac procedures: is HPI truly worthwhile? A systematic review and meta-analysis2025 · 10 citations