Hypotension Prediction Index versus High Mean Arterial Pressure Target for Preventing Intraoperative Hypotension: A Randomized Controlled Trial

doi:10.1097/aln.0000000000006335

Haemodynamics, fluids & transfusion

Hypotension Prediction Index versus High Mean Arterial Pressure Target for Preventing Intraoperative Hypotension: A Randomized Controlled Trial

AnesthesiologyPublished 29 Sep 2026Randomised controlled trial

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Authors' conclusion

HPI-guided management was not superior to a proactive MAP less than or equal to 73 mmHg strategy.

Study context

Population: Adults undergoing major noncardiac surgery requiring invasive arterial monitoringequally randomized
Participants: 100 adults

Comparison: Hypotension Prediction Index (HPI)-guided management vs higher mean arterial pressure (MAP) target
Primary endpoint: Time-weighted average hypotension (MAP <65 mmHg)

Methodological detailsopen-label, parallel-group, two centers

Open-label
Parallel-group
Two centers

Primary result

As reported in the abstract

HPI0.07median · IQR 0–0.20 · mmHg

Higher MAP target0.16median · IQR 0.02–0.50 · mmHg

P = 0.119

Secondary outcomes

Area under the threshold for hypotension

P = 0.172

HPImedian 22 mmHg · minIQR 0–96

Higher MAP targetmedian 59.7 mmHg · minIQR 5.7–119.3

Outcome	P value
Time-weighted average hypertension (MAP >100 mmHg)Did not differ significantly	P = 0.555

Norepinephrine dose, hospital LOS, 30-day mortality

Did not differ significantly

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Hypotension Prediction Index versus High Mean Arterial Pressure Target for Preventing Intraoperative Hypotension: A Randomized Controlled Trial. Anesthesiology. Published 29 September 2026. doi:10.1097/aln.0000000000006335

Read the original article ↗

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