Haemodynamics, fluids & transfusion

Associations between reduction of hypotension and treatment intensity in hypotension prediction index studies

AnesthesiologyPublished Systematic review of randomised trials

Authors' conclusion

Across randomized HPI trials, reduced hypotension was frequently accompanied by increased treatment intensity.

Study context

Population
Randomized trials evaluating Hypotension Prediction Index (HPI)-guided hypotension prevention
Participants
2,342 participants · 20 RCTs
Comparison
Hypotension reduced vs Hypotension not reduced
  • Hypotension reducedn = 13
  • Hypotension not reducedn = fivereference
Outcome
Association between significant reduction in the primary hypotension outcome and significant increase in any hemodynamic treatment (fluids, vasopressors, or inotropes) in the HPI group
Methodological details2×2 tabulation, Fisher's exact test, correlation analysis
  • 2×2 tabulation
  • Fisher's exact test
  • Correlation analysis

Pooled result

As reported in the abstract

Significantly greater treatment intensity in HPI group

Hypotension reduced

69%

9 of 13

Hypotension not reduced

0

events

P = 0.029

Further pooled results

Time-weighted average (TWA) of mean arterial pressure (MAP)< 65 mmHg difference vs treatment intensity category

TWA differences significantly correlated with treatment intensity
P < 0.001

Original publication

Associations between reduction of hypotension and treatment intensity in hypotension prediction index studies. Anesthesiology. Published 9 September 2026. doi:10.1097/aln.0000000000006367

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