Perioperative medicine & outcomes
Effect of individualised versus routine intraoperative blood pressure management on acute kidney injury in noncardiac surgery: a GRADE-assessed meta-analysis of randomised controlled trials
Pooled result · Postoperative AKIResult — go to the resultRelative risk 0.83 95% CI 0.65–1.07Authors' conclusion
Compared with routine intraoperative BP management (typically targeting MAP ≥60-65 mm Hg), individualised intraoperative BP management resulted in higher intraoperative BP but did not significantly reduce postoperative AKI.
Study context
- Population
- Patients having noncardiac surgery
- Participants
- 5,842 patients · 10 randomised controlled trials (RCTs)
- Comparison
- Individualised vs routine intraoperative blood pressure (BP) management
- Outcome
- Incidence of postoperative AKI
Methodological detailsGRADE-assessed, random-effects model with Knapp-Hartung adjustment, Bayesian meta-analysis
- GRADE-assessed
- Random-effects model with Knapp-Hartung adjustment
- Bayesian meta-analysis
Pooled result
Postoperative AKI
Relative risk
0.83
95% CI 0.65–1.07
P = 0.13
Individualised vs Routine
RR 0.83 (95% CI 0.65–1.07); P = 0.13
As reported in the abstract
- Bayesian probability of any degree of acute kidney injury (AKI) protection (RR<1)
- 91%
- Bayesian probability of clinically meaningful benefit (RR<0.8)
- 39%
Further pooled results
| Outcome | Mean difference (mm Hg × min) (95% CI) | P value | |
|---|---|---|---|
| Intraoperative BP (area under MAP of 65 mm Hg) | −44.5 (−58.5 to −30.4) | P = 0.0005 | |
| −100−50050Difference, mm Hg × min (linear scale) |
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| 30-day mortality | 0.78 (0.35–1.75) | P = 0.44 | |
| Myocardial injury | 1.11 (0.92–1.35) | P = 0.14 | |
| 0.20.5125Relative risk (log scale) |
- Intraoperative BP (area under mean arterial pressure (MAP) of 65 mm Hg): significantly higher intraoperative BP with individualised management
AKI, Bayesian analysis
- Probability of any degree of AKI protection (RR<1)
- 91%
- Probability of clinically meaningful benefit (RR<0.8)
- 39%
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Myocardial injury | 1.11 (0.92–1.35) | P = 0.14 | |
| 0.512Relative risk (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effect of individualised versus routine intraoperative blood pressure management on acute kidney injury in noncardiac surgery: a GRADE-assessed meta-analysis of randomised controlled trials. Br J Anaesth. Published 1 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →