Hemodynamics, fluids & transfusion
Tight control of mean arterial pressure using a closed loop system for norepinephrine infusion after high-risk abdominal surgery: a randomized controlled trial
Primary resultResult — go to the resultDifference 37.2 95% CI 23.0–49.2Authors' conclusion
In patients admitted to the ICU after high-risk abdominal surgery, closed-loop control of norepinephrine infusion better maintained a MAP target of 80 to 90 mmHg and significantly decreased postoperative hypotensive when compared to manual norepinephrine titration.
Study context
- Population
- Intensive care unit (ICU) patients after high-risk abdominal surgery; Mean arterial pressure (MAP) target 80–90 mmHg
- Participants
- fifty-three patients
- Comparison
- Closed-loop vasopressor control vs manual norepinephrine titration
- Primary endpoint
- Percentage of time with MAP in target (80-90 mmHg)
- Follow-up
- 2-hour study period
Methodological detailsFluid administration standardized in both groups using an advanced hemodynamic monitoring device
- Fluid administration standardized in both groups using an advanced hemodynamic monitoring device
Primary result
As reported in the abstract
Difference
37.2
95% CI 23.0–49.2
P < 0.001
By group
CLV vs Control
difference 37.2 (95% CI 23.0–49.2); P < 0.001
Further findings
Median, %
| Outcome | CLV | P value |
|---|---|---|
| Percentage time with MAP <80 mmHgCLV vs Control | 1 (IQR 0–5) | P < 0.001 |
| Percentage time with MAP <65 mmHgCLV vs Control | 0 (IQR 0–0) | P = 0.017 |
- Percentage time with MAP <80 mmHg: Control median 26 (IQR 16–75) %
- Percentage time with MAP <65 mmHg: Control median 0 (IQR 0–4) %
Percentage time with MAP >90 mmHg
- Not statistically different between groups
Original publication
Tight control of mean arterial pressure using a closed loop system for norepinephrine infusion after high-risk abdominal surgery: a randomized controlled trial. J Clin Monit Comput. Published 18 December 2023. doi:10.
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