New-onset postoperative hypotension in patients recovering from noncardiac surgery: A prospective observational study.

IF 6.8 2区 医学 Q1 ANESTHESIOLOGY
Phillip Hoppe, Yuan Chang, Tobias Schwarz, Alina Bergholz, Kristen K Thomsen, Alina Kröker, Moritz Flick, Linda Krause, Daniel I Sessler, Bernd Saugel
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引用次数: 0

Abstract

Background: It remains unknown whether postoperative mean arterial pressures less than 65 mmHg constitute clinically important hypotension for individual patients, or might be within their normal pressure range.

Objective: We aimed to evaluate postoperative arterial pressure in patients recovering from noncardiac surgery and determine the proportion of patients in whom a mean arterial pressure less than 65 mmHg constitutes new-onset postoperative hypotension.

Design: A prospective observational study.

Setting: German university medical centre between October 2020 and September 2021.

Patients: Patients with elevated cardiovascular risk recovering on general wards from noncardiac surgery under general anaesthesia.

Main outcome measures: Before and after surgery, we automatically measured arterial pressure at 30-min intervals for about 24 h. We considered patients to have new-onset postoperative hypotension when they had a postoperative mean arterial pressure less than 65 mmHg, and their lowest postoperative mean arterial pressure was at least 5 mmHg below their lowest pre-operative mean arterial pressure.

Results: We enrolled 307 patients and included 248 in the final analysis. The median [IQR] duration of surgery was 62 [40 to 90] min. Postoperative mean arterial pressure was less than 65 mmHg at least once in 101 patients (41%). In 44 of these 101 patients (44%; 18% of all 248 patients), postoperative mean arterial pressures less than 65 mmHg constituted new-onset postoperative hypotension. In 57 of these 101 patients (56%; 23% of all 248 patients), postoperative mean arterial pressures less than 65 mmHg did not constitute new-onset postoperative hypotension.

Conclusion: About 40% of our patients recovering from noncardiac surgery on general wards had at least one postoperative mean arterial pressure less than 65 mmHg, and about half of these patients had new-onset postoperative hypotension.

非心脏手术患者术后新发低血压:一项前瞻性观察研究。
背景:对于个别患者,术后平均动脉压低于65 mmHg是否构成临床上重要的低血压,或者可能在正常血压范围内,目前尚不清楚。目的:我们旨在评估非心脏手术恢复患者的术后动脉压,并确定平均动脉压低于65 mmHg构成术后新发低血压的患者比例。设计:前瞻性观察性研究。地点:德国大学医学中心,2020年10月至2021年9月。患者:全麻下非心脏手术后在普通病房恢复的心血管风险增高患者。主要观察指标:手术前后,我们每隔30分钟自动测量动脉压,持续约24小时。当患者术后平均动脉压低于65 mmHg,且其术后最低平均动脉压比术前最低平均动脉压至少低5 mmHg时,我们认为患者为术后新发低血压。结果:共纳入307例患者,最终纳入248例。手术中位[IQR]持续时间为62[40 ~ 90]分钟。101例(41%)患者术后平均动脉压至少一次低于65 mmHg。101例患者中有44例(44%;248例患者中18%),术后平均动脉压低于65 mmHg构成术后新发低血压。101例患者中有57例(56%;248例患者中的23%),术后平均动脉压小于65 mmHg不构成术后新发低血压。结论:约40%的普通病房非心脏手术患者术后至少一次平均动脉压低于65 mmHg,其中约一半患者出现术后新发低血压。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.90
自引率
11.10%
发文量
351
审稿时长
6-12 weeks
期刊介绍: The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
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