Intraoperative blood pressure management in noncardiac surgery: a narrative review based on current evidence - PubMed
4 days ago
- #Intraoperative hypotension
- #Noncardiac surgery
- #Haemodynamic management
- Intraoperative blood pressure management in noncardiac surgery is closely monitored, but optimal targets remain uncertain.
- Observational studies show associations between MAP 60-70 mmHg and postoperative complications like myocardial injury, acute kidney injury, and mortality.
- International recommendations suggest avoiding MAP below 60-65 mmHg.
- Randomized controlled trials (RCTs) indicate that higher or individualized MAP thresholds do not significantly improve patient outcomes compared to routine care (MAP ≥ 65 mmHg).
- Emerging evidence suggests hypotension reflects heterogeneous haemodynamic endotypes, explaining why uniform pressure targets may not improve outcomes.
- Advanced monitoring techniques like continuous blood pressure monitoring, predictive analytics, and closed-loop vasopressor systems help reduce hypotension exposure.
- Future progress may depend on mechanistic endotyping, advanced monitoring integration, and precision-guided haemodynamic strategies.
- Conflicts of interest among authors include ownership stakes, research funding, and consulting fees from medical technology companies.