Key result
Higher alarm thresholds for arterial blood pressure significantly reduced the risk of patients experiencing at least one intraoperative hypotensive episode compared to lower thresholds (OR 0.84).
Why the study?
Intraoperative hypotension increases risk for postoperative organ dysfunction, but evidence is limited on whether higher patient monitor alarm thresholds help prevent it.
Do higher alarm thresholds for arterial blood pressure reduce perioperative hypotension in patients undergoing noncardiac surgery?
Cohort (n=4,222)
No
Do higher alarm thresholds for arterial blood pressure reduce perioperative hypotension in patients undergoing noncardiac surgery?
Odds Ratio: 0.84 (95% CI 0.72–0.98)
Absolute Event Rate: 74.46% vs 80.32%
p-value: p=0.029
Implementing higher alarm thresholds for arterial blood pressure slightly reduced the occurrence of at least one intraoperative hypotensive episode, but did not change the overall proportion of hypotensive measurements.
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Associated with fewer hypotensive episodes; hypothesis-generating for alarm optimization, should not yet change practice.
Meidert et al. (2022) conducted a cohort in Noncardiac surgery (n=4,222). Higher alarm thresholds for arterial blood pressure vs. Lower alarm thresholds (pre-update) was evaluated on Procedures with at least one hypotensive event (MAP < 65 mmHg) (OR 0.84, 95% CI 0.72-0.98, p=0.029). Higher alarm thresholds for arterial blood pressure significantly reduced the risk of patients experiencing at least one intraoperative hypotensive episode compared to lower thresholds (OR 0.84).
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