Continuing versus Withholding renin angiotensin aldosterone system antagonists before non-cardiac surgery: A protocol of a systematic review and meta-analysis - PubMed
4 hours ago
- #non-cardiac surgery
- #renin-angiotensin system
- #meta-analysis
- The study examines the effects of continuing versus withholding ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) before non-cardiac surgery.
- Perioperative use of ACEIs/ARBs may cause postinduction hypotension, leading to complications like acute renal injury or stroke, but the link to major morbidity is unclear.
- The meta-analysis aims to compare outcomes (hemodynamic instability, mortality, major morbidity) between continuing or discontinuing ACEIs/ARBs perioperatively.
- Inclusion criteria involve studies on adults over 18 with chronic hypertension undergoing non-cardiac surgery, where ACEIs/ARBs were withheld or continued <10 hours pre-surgery.
- Primary outcome: incidence of intraoperative hypotension. Secondary outcomes include vasoactive agent use, severe hypotension, hospital stay, acute kidney injury, 30-day mortality, and cardio-cerebral events.
- The protocol is registered in PROSPERO (ID: CRD42024519162), with searches planned in Medline, Embase, Scopus, and Web of Science up to August 30, 2024.
- Findings may guide clinical decisions on perioperative ACEI/ARB use in non-cardiac surgery.