2019
DOI: 10.1016/j.bja.2019.01.013
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Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery

Abstract: Background: Intraoperative mortality is now rare, but death within 30 days of surgery remains surprisingly common. Perioperative myocardial infarction is associated with a remarkably high mortality. There are strong associations between hypotension and myocardial injury, myocardial infarction, renal injury, and death. Perioperative arterial blood pressure management was thus the basis of a Perioperative Quality Initiative consensus-building conference held in London in July 2017. Methods: The meeting featured … Show more

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Cited by 434 publications
(375 citation statements)
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References 44 publications
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“…Thus, it can be argued that in the absence of other competing clinical requirements the SBP should be maintained in three sensible digits. This is also compatible with the findings of the Peri-operative Quality Initiative group [22]. Maintaining the SBP in three sensible digits has other advantages, including tangibility for novice anaesthetists.…”
supporting
confidence: 88%
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“…Thus, it can be argued that in the absence of other competing clinical requirements the SBP should be maintained in three sensible digits. This is also compatible with the findings of the Peri-operative Quality Initiative group [22]. Maintaining the SBP in three sensible digits has other advantages, including tangibility for novice anaesthetists.…”
supporting
confidence: 88%
“…The ABCD mnemonic is a useful aide memoire. However, contemporary studies have demonstrated that the presence of an ABC is not always sufficient to prevent end‐organ dysfunction, as among other clinical variables, hypotension, tachycardia and dysglycaemia are associated with poor outcome . This concept is also in line with the aviation checklist proposed by Jelacic et al., as they advocate the necessity of agreeing blood pressure and heart rate goals before commencement of anaesthesia .…”
mentioning
confidence: 92%
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“…124,125 Studies of intraoperative hypotension are complicated by the fact that there is no consensus on what constitutes hypotension, 126 which perhaps underscores again that patients' cerebral autoregulatory curves are highly individualised. 120,127,128 It follows that the only way to ensure adequate brain perfusion in a given patient would be to measure or monitor it in some way.…”
Section: Preventionmentioning
confidence: 99%