Intraoperative Hypotension
CA-2 · I.C.3.a.4 II.C.3.b.6.a.9 I.B.1.d.5
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Mean arterial pressures below 60-70 mmHg are associated with myocardial injury, acute kidney injury and death, and the injury is a function of both how far the pressure falls and how long it stays there.
PMID 30916004
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Organ injury is reported after 10 minutes or more below a mean arterial pressure of 80 mmHg, after shorter periods below 70 mmHg, and at any exposure below 55-50 mmHg.
PMID 30236233
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Hypotension on the four days after surgery carried a far stronger association with myocardial infarction and death (odds ratio 2.83) than each extra 10 minutes of intraoperative hypotension (odds ratio 1.08).
PMID 29189290
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Cumulative intraoperative norepinephrine dose is independently associated with postoperative acute kidney injury, so escalating vasopressor to chase a pressure target is not a risk-free trade.
PMID 39672776
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Targeting a MAP of at least 75 mmHg instead of 60 mmHg cut time spent below 65 mmHg by roughly 60% but did not reduce acute myocardial injury or 30-day major cardiac events and acute kidney injury.
PMID 34711333
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A maximum intraoperative heart rate above 100 bpm together with a minimum systolic pressure below 100 mmHg is more strongly associated with myocardial injury than low systolic pressure alone.
PMID 29077608
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