Hemodynamics, fluids & transfusion
Closed-loop versus manual vasopressor titration for blood pressure control in surgical and critically ill patients: A systematic review and meta-analysis of randomised trials
Pooled resultResult — go to the resultMD −15.81 % 95% CI −20.38 to −11.25%Authors' conclusion
In surgical and critically-ill patients, closed-loop systems were associated with improved adherence to predefined blood pressure targets with reduced time below target and increased time in target compared to manual vasopressor titration.
Study context
- Population
- Adults receiving vasopressors in perioperative and critical care settings
- Participants
- 640 adults · 8 RCTs
- Comparison
- Closed-loop vasopressor vs manual vasopressor titration
- Outcome
- Time below target
Methodological detailsPRISMA-guided, 5 trials in the operating room, 3 in the ICU
- PRISMA-guided
- 5 trials in the operating room, 3 in the ICU
Pooled result
As reported in the abstract
MD
−15.81 %
95% CI −20.38 to −11.25%
P < 0.001
CLV vs Manual titration
MD −15.81 % (95% CI −20.38 to −11.25%); P < 0.001
Further pooled results
| Outcome | MD (%) (95% CI) | P value | |
|---|---|---|---|
| Time in targetn = 216 | 30.18 (21.91–38.44%) | P < 0.001 | |
| −2002040Difference, % (linear scale) |
| Outcome | SMD (95% CI) | P value | |
|---|---|---|---|
| Time in hypotension (MAP <65 mmHg)I2 = 79% | −0.90 (−1.64 to −0.17) | P = 0.02 | |
| −2−101Difference (linear scale) |
| Outcome | MD (days) (95% CI) | P value | |
|---|---|---|---|
| Hospital LOSI2 = 0%; n = 158 | −1.12 (−2.21 to −0.04 days) | P = 0.04 | |
| −3−2−101Difference, days (linear scale) |
| Outcome | MD (min) (95% CI) | P value | |
|---|---|---|---|
| PACU-ICU LOSI2 = 0%; n = 198 · did not differ between the two groups | −0.05 (−1.10 to 1.00 min) | P = 0.93 | |
| −1.5−1−0.500.511.5Difference, min (linear scale) |
Original publication
Closed-loop versus manual vasopressor titration for blood pressure control in surgical and critically ill patients: A systematic review and meta-analysis of randomised trials. J Clin Anesth. Published 7 May 2026. doi:10.
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