Intraoperative Implementation of the Hypotension Probability Indicator

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)100 enrolled

Overview

Reducing intraoperative hypotension using FlotracIQ with HPI software.

Intraoperative hypotension occurs often. Even short durations of hypotension are suggested to be associated with increased risk for renal insufficiency and myocardial ischemia. Currently treatment of these hypotensive episodes is not proactive. Edwards Lifesciences has developed an algorithm using continuous invasively-measured arterial waveforms to predict hypotension with high accuracy minutes before blood pressure actually decreases. Hypothesis: the use of this algorithm will alter treatment of hypotension and reduces the incidence of hypotension.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

100

Conditions

Intraoperative Hypotension

Interventions

FlotracIQ with HPI algorithmDEVICE

FlotracIQ with hypotension probability indicator (HPI) algorithm connected to arterial line. The treating anesthetist is provided with guidance by means of a flowchart suggesting when to treat and what. Timing of treatment and choice of treatment is then left to the discretion of the attending physician.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18 years or older * Planned for elective non-cardiac non-day surgery with an expected duration of more than 2 hours * Planned to receive general anaesthesia * Planned to receive an arterial line during surgery * Aim for MAP of 65 mmHg during surgery * Being able to give written informed consent prior to surgery Exclusion Criteria: * Aim for MAP other than 65 mmHg at discretion treating physician * Significant hypotension before surgery defined as a MAP \<65 * Right- or left sided cardiac failure (e.g. LVEF\<35%) * Known cardiac shunts (significant) * Known aortic stenosis (severe) * Severe cardiac arrhythmias including atrial fibrillation * Requiring dialysis * Liver surgery * Vascular surgery with clamping of the aorta * Perioperative Goal Directed Therapy (PGDT) protocol

Locations (1)

Academic Medical Center Amsterdam

Amsterdam, Netherlands