Proactive haemodynamic management using the hypotension prediction index during caesarean section: a randomised controlled study - PubMed
5 days ago
- #caesarean section
- #haemodynamic management
- #hypotension prediction index
- The study investigated the effectiveness of hypotension prediction index (HPI)-guided management in reducing intra-operative hypotension during caesarean sections compared to oscillometric and continuous non-invasive arterial pressure (CNAP) monitoring.
- 171 patients undergoing elective caesarean section under spinal anaesthesia were randomly assigned to one of three monitoring groups: oscillometric blood pressure, CNAP, or HPI-guided monitoring.
- The primary outcome was the time-weighted average of hypotension (mean arterial pressure < 65 mmHg). Secondary outcomes included hypertension (≥ 100 mmHg) and maternal adverse effects like nausea and vomiting.
- Results showed that the HPI group had significantly lower time-weighted average hypotension (0.08 mmHg) compared to oscillometric (0.89 mmHg) and CNAP (0.30 mmHg) groups (p < 0.001).
- Patients in the oscillometric group experienced higher incidences of nausea and vomiting compared to the CNAP and HPI groups.
- The study concluded that HPI-guided management significantly reduces intra-operative hypotension without increasing hypertension risk, offering a proactive strategy for haemodynamic optimisation in obstetric anaesthesia.