Pro: Routine Use of the Hypotension Prediction Index (HPI) in Cardiac, Thoracic, and Vascular Surgery

Awadallah, Doaa; Thomas, Geoffrey; Saklayen, Samiya; Dalton, Ryan; Awad, Hamdy

doi:10.1053/j.jvca.2020.11.048

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…It predicts hypotension 15 min in advance and is faster than cardiac output, stroke volume, MAP, pulse pressure, heart rate, stroke volume variation, and the shock index [ 8 ]. The benefit of the HPI in major cardiac, thoracic, and vascular surgery has been demonstrated, where maintaining intraoperative haemodynamic stability is important [ 28 ]. Despite its initial purpose, we utilised the HPI to intentionally induce intraoperative hypotension, not to prevent hypotension.…”

Section: Discussionmentioning

confidence: 99%

Clinical Implication of the Acumen Hypotension Prediction Index for Reducing Intraoperative Haemorrhage in Patients Undergoing Lumbar Spinal Fusion Surgery: A Prospective Randomised Controlled Single-Blinded Trial

Koo

Choi

Hwang

et al. 2022

JCM

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We investigated the clinical implication of the Hypotension Prediction Index (HPI) in decreasing amount of surgical haemorrhage and requirements of blood transfusion compared to the conventional method (with vs. without HPI monitoring). A prospective, randomised controlled-trial of 19- to 73-year-old patients (n = 76) undergoing elective lumbar spinal fusion surgery was performed. According to the exclusion criteria, the patients were divided into the non-HPI (n = 33) and HPI (n = 35) groups. The targeted-induced hypotension systolic blood pressure was 80–100 mmHg (in both groups), with HPI > 85 (in the HPI group). Intraoperative bleeding was lower in the HPI group (299.3 ± 219.8 mL) than in the non-HPI group (532 ± 232.68 mL) (p = 0.001). The non-HPI group had a lower level of haemoglobin at the end of the surgery with a larger decline in levels. The incidence of postoperative transfusion of red blood cells was higher in the non-HPI group than in the HPI group (9 (27.3%) vs. 1 (2.9%)). The use of HPI monitoring may play a role in providing timely haemodynamic information that leads to improving the quality of induced hypotension care and to ameliorate intraoperative surgical blood loss and postoperative demand for blood transfusion in patients undergoing lumbar fusion surgery.

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Section: Discussionmentioning

confidence: 99%

Clinical Implication of the Acumen Hypotension Prediction Index for Reducing Intraoperative Haemorrhage in Patients Undergoing Lumbar Spinal Fusion Surgery: A Prospective Randomised Controlled Single-Blinded Trial

Koo

Choi

Hwang

et al. 2022

JCM

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“…[ 8 ] Various studies document the successful use of HPI in cardiac and non-cardiac surgeries. [ 9 10 11 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…While there is no standard definition of IOH, an absolute systolic pressure less than 100 mmHg with or without a relative decrease of 30% from baseline, is usually used to clinically identify IOH. [ 12 ] Given the accepted working definition, a MAP up to 60 mmHg would be acceptable in normotensive patients while known hypertensive patients may require a higher MAP for organ perfusion. [ 15 ] As a result, the software would be rendered incapable of accurately predicting hypotensive episodes in a significant proportion of the patient population.…”

Section: Discussionmentioning

confidence: 99%

The use of Hypotension Prediction Index in cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC)

Solanki

Gangakhedkar

Divatia

2022

Indian Journal of Anaesthesia

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“…The latter parameter (dP/dt) is well correlated with the left ventricle elastance and reflects cardiac contractility,. 2–7…”

Section: To the Editormentioning

confidence: 99%

Selection Bias in the Hypotension Prediction Index: Comment

Giustiniano

Nisi²

2023

Anesthesiology

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Pro: Routine Use of the Hypotension Prediction Index (HPI) in Cardiac, Thoracic, and Vascular Surgery

Cited by 8 publications

References 15 publications

Clinical Implication of the Acumen Hypotension Prediction Index for Reducing Intraoperative Haemorrhage in Patients Undergoing Lumbar Spinal Fusion Surgery: A Prospective Randomised Controlled Single-Blinded Trial

Clinical Implication of the Acumen Hypotension Prediction Index for Reducing Intraoperative Haemorrhage in Patients Undergoing Lumbar Spinal Fusion Surgery: A Prospective Randomised Controlled Single-Blinded Trial

The use of Hypotension Prediction Index in cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC)

Selection Bias in the Hypotension Prediction Index: Comment

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