Continuous Vs Intermittent Non Invasive Blood Pressure Monitoring in Preventing Post Operative Organ Failure

University of Messina1,267 enrolled

Overview

Continuous non-invasive arterial pressure monitoring has the potential to decrease the duration of intraoperative hypotension and hypertension compared to conventional intermittent blood pressure monitoring. Chen et al. demonstrated using continuous non-invasive arterial pressure devices for every hour of surgery it is possible to identify an average of 14 minutes of potentially treatable hypotensive and hypertensive time(12). Whether the ability to detect more hypotension events by continuous non-invasive arterial pressure monitoring use can improve patient outcomes, is still an open research question

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

1,267

Conditions

Blood Pressure Determination Hemodynamic Monitoring Postoperative Complications

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All adult (age ≥18 years) patients scheduled for elective non-cardiac surgery in participating centers * Surgical case planned with non invasive blood pressure monitoring according to local clinical practice or policies. Exclusion Criteria: * Missing of preoperative serum creatinine during 30 days prior surgery * Preoperative dialysis * Chronic kidney disease (eGFR \< 60ml/min Cockcroft-Gault equation) * Surgical procedure lasting less than 60 min * Planned use of permissive hypotension * Urological procedures (including nephrectomy and renal transplantation) * Refusal to give informed consent

Outcomes

Primary Outcomes

Post operative myocardial injury

The primary outcome will be the proportions of myocardial injury (Definitions: elevation of serum Troponin T (TnT) \>= 30 ng/L in the first post-operative week)

Time frame: 1 week

Secondary Outcomes

Post operative Acute kidney injury

Proportions of postoperative AKI (Definition: increase in postoperative serum creatinine concentration during the first 7 postoperative days by more than 1.5-fold or greater than 0.3 mg/dl. Preoperative concentration was defined as the most recent recorded measurement within 30 days before the surgery)

Time frame: 1 week

Post operative death

Death during postoperative hospital stay

Time frame: 28 day after surgery

Events 30d post surgery

Any of the following events after surgery: Stroke, Non fatal cardiac arrest, AKI stage 2-3, Sepsis, Death)

Time frame: 30 days after surgery

Events 90d post surgery