Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches
Intraoperative hypotension (IOH) i.e., low arterial blood pressure (AP) during surgery is common in patients having non-cardiac surgery under general anaesthesia. It has a multifactorial aetiology, and is associated with major postoperative complications including acute kidney injury, myocardial inj...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2020;volume=64;issue=2;spage=90;epage=96;aulast=Kouz |
| _version_ | 1828385731772416000 |
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| author | Karim Kouz Phillip Hoppe Luisa Briesenick Bernd Saugel |
| author_facet | Karim Kouz Phillip Hoppe Luisa Briesenick Bernd Saugel |
| author_sort | Karim Kouz |
| collection | DOAJ |
| description | Intraoperative hypotension (IOH) i.e., low arterial blood pressure (AP) during surgery is common in patients having non-cardiac surgery under general anaesthesia. It has a multifactorial aetiology, and is associated with major postoperative complications including acute kidney injury, myocardial injury and death. Therefore, IOH may be a modifiable risk factor for postoperative complications. However, there is no uniform definition for IOH. IOH not only occurs during surgery but also after the induction of general anaesthesia before surgical incision. However, the optimal therapeutic approach to IOH remains elusive. There is evidence from one small randomised controlled trial that individualising AP targets may reduce the risk of postoperative organ dysfunction compared with standard care. More research is needed to define individual AP harm thresholds, to develop therapeutic strategies to treat and avoid IOH, and to integrate new technologies for continuous AP monitoring. |
| first_indexed | 2024-12-10T05:24:58Z |
| format | Article |
| id | doaj.art-f8941a08cc5e4a26bb50469641b4438e |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-12-10T05:24:58Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-f8941a08cc5e4a26bb50469641b4438e2022-12-22T02:00:43ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172020-01-01642909610.4103/ija.IJA_939_19Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approachesKarim KouzPhillip HoppeLuisa BriesenickBernd SaugelIntraoperative hypotension (IOH) i.e., low arterial blood pressure (AP) during surgery is common in patients having non-cardiac surgery under general anaesthesia. It has a multifactorial aetiology, and is associated with major postoperative complications including acute kidney injury, myocardial injury and death. Therefore, IOH may be a modifiable risk factor for postoperative complications. However, there is no uniform definition for IOH. IOH not only occurs during surgery but also after the induction of general anaesthesia before surgical incision. However, the optimal therapeutic approach to IOH remains elusive. There is evidence from one small randomised controlled trial that individualising AP targets may reduce the risk of postoperative organ dysfunction compared with standard care. More research is needed to define individual AP harm thresholds, to develop therapeutic strategies to treat and avoid IOH, and to integrate new technologies for continuous AP monitoring.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2020;volume=64;issue=2;spage=90;epage=96;aulast=Kouzacute kidney injuryblood pressurehaemodynamic monitoringmyocardial injury after non-cardiac surgerypostoperative complications |
| spellingShingle | Karim Kouz Phillip Hoppe Luisa Briesenick Bernd Saugel Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches Indian Journal of Anaesthesia acute kidney injury blood pressure haemodynamic monitoring myocardial injury after non-cardiac surgery postoperative complications |
| title | Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches |
| title_full | Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches |
| title_fullStr | Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches |
| title_full_unstemmed | Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches |
| title_short | Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches |
| title_sort | intraoperative hypotension pathophysiology clinical relevance and therapeutic approaches |
| topic | acute kidney injury blood pressure haemodynamic monitoring myocardial injury after non-cardiac surgery postoperative complications |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2020;volume=64;issue=2;spage=90;epage=96;aulast=Kouz |
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