Haemodynamics, fluids & transfusion
Perioperative goal-directed therapy with artificial intelligence to reduce the incidence of intraoperative hypotension and renal failure in patients undergoing lung surgery: A pilot study
Authors' conclusion
The implementation of a treatment algorithm based on HPI allowed us to decrease the duration and severity of hypotension in patients undergoing lung surgery. It did not result in a significant reduction in the incidence of AKI, however we observed a tendency towards lower incidence of MINS in the intervention group, along with a slight reduction in postoperative infections.
Study context
- Population
- Patients undergoing lung surgery with single lung ventilation, university hospital
- Participants
- 150 patients
- Comparison
- Hypotension Prediction Index (HPI)-based goal-directed therapy vs standard care
- Primary endpoint
- Frequency and duration of intraoperative hypotension, area under MAP 65 and time-weighted average (TWA) of MAP 65
Methodological detailssingle center, single-blinded, pilot study
- Single center
- Single-blinded
- Pilot study
Primary result
As reported in the abstract
- Intervention
- Number of hypotensive episodes, median [IQR] 0 [0-1] vs. 1 [0-2]; P = 0.01
- Intervention
- Duration of hypotension 0 min [0-3.17] vs. 2.33 min [0-7.42] min; P = 0.01
- Intervention
- Area under MAP of 65 0 mmHg * min [0-12] vs. 10.67 mmHg * min [0-44.16] mmHg * min; P < 0.01
- Intervention
- Time-weighted average (TWA) of MAP of 65 0 mmHg [0-0.08] vs. 0.07 mmHg [0-0.25] mmHg; P < 0.01
Further findings
MINS · trend to lower incidence in the intervention group
P = 0.07
Postoperative infection · tendency towards reduction in the intervention group
P = 0.16
| Outcome | P value |
|---|---|
| Postoperative AKINo differences between the groups | P = 0.72 |
- Postoperative acute kidney injury (AKI) — Incidence of postoperative AKI, no differences between the groups
- 6.7 % vs.4.2 %
Original publication
Perioperative goal-directed therapy with artificial intelligence to reduce the incidence of intraoperative hypotension and renal failure in patients undergoing lung surgery: A pilot study. J Clin Anesth. Published 14 February 2025. doi:10.
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