医学
病因学
血管内容积状态
收缩性
麻醉
不利影响
冲程容积
心脏病学
血压
血流动力学
重症监护医学
麻醉学
内科学
心率
作者
Hamdy Awad,Gabriel Alcodray,Arwa Raza,Racha Boulos,Michael Essandoh,Sujatha Bhandary,Ryan Dalton
标识
DOI:10.1053/j.jvca.2021.05.057
摘要
Intraoperative hypotension (IOH) is a major concern to the anesthesiologist. Its appropriate identification and management require an understanding of the physiology of blood pressure regulation, prudent blood pressure monitoring, and treatment. Even short durations of low mean arterial pressure have been associated with adverse postoperative clinical outcomes. The challenge is for the clinician to respond proactively, address the specific etiology of IOH, and keep in mind any changes to the patient's physiology. Predictive technology, such as the Hypotension Prediction Index, offers the clinician new insight into IOH. It has been shown to predict hypotension up to 15 minutes before occurrence. It also calculates stroke volume variation, dynamic arterial elastance, and left ventricular contractility, which can inform the anesthesiologist of the etiology of IOH to direct management. This new technology has the potential to reduce duration or even prevent IOH. In the authors' opinion, it is an example of how human-machine interaction will contribute to future advances in medicine. Additional studies should evaluate the effects of its use on postoperative outcomes.
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