Automated Blood Pressure Control

Joseph Rinehart; Sean Lee; Bernd Saugel; Alexandre Joosten

doi:10.1055/s-0040-1713083

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2021; 42(01): 047-058
DOI: 10.1055/s-0040-1713083

Review Article

Automated Blood Pressure Control

Joseph Rinehart

¹Department of Anesthesiology and Perioperative Care, University of California Irvine, Orange, California

,

Sean Lee

¹Department of Anesthesiology and Perioperative Care, University of California Irvine, Orange, California

,

Bernd Saugel

²Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

³Outcomes Research Consortium, Cleveland, Ohio

,

Alexandre Joosten

⁴Department of Anesthesiology, Erasme Hospital, Brussels, Belgium

⁵Department of Anesthesiology and Intensive Care, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Université Paris-Saclay, Hôpital De Bicêtre, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France

› Institutsangaben

Abstract

Arterial pressure management is a crucial task in the operating room and intensive care unit. In high-risk surgical and in critically ill patients, sustained hypotension is managed with continuous infusion of vasopressor agents, which most commonly have direct α agonist activity like phenylephrine or norepinephrine. The current standard of care to guide vasopressor infusion is manual titration to an arterial pressure target range. This approach may be improved by using automated systems that titrate vasopressor infusions to maintain a target pressure. In this article, we review the evidence behind blood pressure management in the operating room and intensive care unit and discuss current and potential future applications of automated blood pressure control.

Keywords

blood pressure - automation - vasopressors - closed-loop - intraoperative hypotension

Volltext

Referenzen

References
1 Erturk E. Ischemia-reperfusion injury and volatile anesthetics. BioMed Res Int 2014; 2014: 526301
2 Takala J. Should we target blood pressure in sepsis?. Crit Care Med 2010; 38 (10) S613-S619
3 Kato R, Pinsky MR. Personalizing blood pressure management in septic shock. Ann Intensive Care 2015; 5 (01) 41
4 Houwink AP, Rijkenberg S, Bosman RJ, van der Voort PH. The association between lactate, mean arterial pressure, central venous oxygen saturation and peripheral temperature and mortality in severe sepsis: a retrospective cohort analysis. Crit Care 2016; 20 (01) 56
5 Maheshwari K, Nathanson BH, Munson SH. et al. The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med 2018; 44 (06) 857-867
6 Keuffel EL, Stevens M, Gunnarsson C, Rizzo J, Sessler DI, Maheshwari K. A Monte Carlo simulation estimating US hospital cost reductions associated with hypotension control in septic ICU patients. J Med Econ 2019; 22 (04) 383-389
7 Sabaté S, Mases A, Guilera N. et al; ANESCARDIOCAT Group. Incidence and predictors of major perioperative adverse cardiac and cerebrovascular events in non-cardiac surgery. Br J Anaesth 2011; 107 (06) 879-890
8 Bijker JB, Persoon S, Peelen LM. et al. Intraoperative hypotension and perioperative ischemic stroke after general surgery: a nested case-control study. Anesthesiology 2012; 116 (03) 658-664
9 Radinovic K, Markovic Denic L, Milan Z, Cirkovic A, Baralic M, Bumbasirevic V. Impact of intraoperative blood pressure, blood pressure fluctuation, and pulse pressure on postoperative delirium in elderly patients with hip fracture: a prospective cohort study. Injury 2019; 50 (09) 1558-1564
10 Sun LY, Wijeysundera DN, Tait GA, Beattie WS. Association of intraoperative hypotension with acute kidney injury after elective noncardiac surgery. Anesthesiology 2015; 123 (03) 515-523
11 van Waes JA, van Klei WA, Wijeysundera DN, van Wolfswinkel L, Lindsay TF, Beattie WS. Association between intraoperative hypotension and myocardial injury after vascular surgery. Anesthesiology 2016; 124 (01) 35-44
12 Roshanov PS, Sheth T, Duceppe E. et al. Relationship between perioperative hypotension and perioperative cardiovascular events in patients with coronary artery disease undergoing major noncardiac surgery. Anesthesiology 2019; 130 (05) 756-766
13 Willingham MD, Karren E, Shanks AM. et al. Concurrence of intraoperative hypotension, low minimum alveolar concentration, and low bispectral index is associated with postoperative death. Anesthesiology 2015; 123 (04) 775-785
14 Walsh M, Devereaux PJ, Garg AX. et al. Relationship between intraoperative mean arterial pressure and clinical outcomes after noncardiac surgery: toward an empirical definition of hypotension. Anesthesiology 2013; 119 (03) 507-515
15 Salmasi V, Maheshwari K, Yang D. et al. Relationship between intraoperative hypotension, defined by either reduction from baseline or absolute thresholds, and acute kidney and myocardial injury after noncardiac surgery: a retrospective cohort analysis. Anesthesiology 2017; 126 (01) 47-65
16 Stapelfeldt WH, Yuan H, Dryden JK. et al. The SLUScore: a novel method for detecting hazardous hypotension in adult patients undergoing noncardiac surgical procedures. Anesth Analg 2017; 124 (04) 1135-1152
17 Monk TG, Bronsert MR, Henderson WG. et al. Association between intraoperative hypotension and hypertension and 30-day postoperative mortality in noncardiac surgery. Anesthesiology 2015; 123 (02) 307-319
18 Futier E, Lefrant JY, Guinot PG. et al; INPRESS Study Group. Effect of individualized vs standard blood pressure management strategies on postoperative organ dysfunction among high-risk patients undergoing major surgery: a randomized clinical trial. JAMA 2017; 318 (14) 1346-1357
19 Jinadasa SP, Mueller A, Prasad V. et al. Blood pressure coefficient of variation and its association with cardiac surgical outcomes. Anesth Analg 2018; 127 (04) 832-839
20 Wiórek A, Krzych LJ. Intraoperative blood pressure variability predicts postoperative mortality in non-cardiac surgery-a prospective observational cohort study. Int J Environ Res Public Health 2019; 16 (22) E4380
21 Ying LD, Duffy AJ, Roberts KE, Ghiassi S, Hubbard MO, Nadzam GS. Intraoperative blood pressure lability is associated with postoperative hemorrhage after uncomplicated bariatric surgery. Obes Surg 2019; 29 (06) 1990-1994
22 Li J, Zhao Y, Zhao M. et al. High variance of intraoperative blood pressure predicts early cerebral infarction after revascularization surgery in patients with Moyamoya disease. Neurosurg Rev 2019, Jun 15; [Epub ahead of print]
23 Keuffel EL, Rizzo J, Stevens M, Gunnarsson C, Maheshwari K. Hospital costs associated with intraoperative hypotension among non-cardiac surgical patients in the US: a simulation model. J Med Econ 2019; 22 (07) 645-651
24 Sessler DI, Bloomstone JA, Aronson S. et al; Perioperative Quality Initiative-3 workgroup, POQI chairs, Physiology group, Preoperative blood pressure group, Intraoperative blood pressure group, Postoperative blood pressure group. Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Br J Anaesth 2019; 122 (05) 563-574
25 Yealy DM, Kellum JA, Huang DT. et al; ProCESS Investigators. A randomized trial of protocol-based care for early septic shock. N Engl J Med 2014; 370 (18) 1683-1693
26 Asfar P, Meziani F, Hamel JF. et al; SEPSISPAM Investigators. High versus low blood-pressure target in patients with septic shock. N Engl J Med 2014; 370 (17) 1583-1593
27 Lamontagne F, Cook DJ, Meade MO. et al. Vasopressor use for severe hypotension-a multicentre prospective observational study. PLoS One 2017; 12 (01) e0167840
28 Herget-Rosenthal S, Saner F, Chawla LS. Approach to hemodynamic shock and vasopressors. Clin J Am Soc Nephrol 2008; 3 (02) 546-553
29 Yapps B, Shin S, Bighamian R. et al. Hypotension in ICU patients receiving vasopressor therapy. Sci Rep 2017; 7 (01) 8551
30 Hawryluk G, Whetstone W, Saigal R. et al. Mean arterial blood pressure correlates with neurological recovery after human spinal cord injury: analysis of high frequency physiologic data. J Neurotrauma 2015; 32 (24) 1958-1967
31 Rinehart J, Ma M, Calderon MD. et al. Blood pressure variability in surgical and intensive care patients: Is there a potential for closed-loop vasopressor administration?. Anaesth Crit Care Pain Med 2019; 38 (01) 69-71
32 Annane D, Vignon P, Renault A. et al; CATS Study Group. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet 2007; 370 (9588): 676-684
33 Bakker J, Grover R, McLuckie A. et al; Glaxo Wellcome International Septic Shock Study Group. Administration of the nitric oxide synthase inhibitor NG-methyl-L-arginine hydrochloride (546C88) by intravenous infusion for up to 72 hours can promote the resolution of shock in patients with severe sepsis: results of a randomized, double-blind, placebo-controlled multicenter study (study no. 144-002). Crit Care Med 2004; 32 (01) 1-12
34 Bollaert PE, Charpentier C, Levy B, Debouverie M, Audibert G, Larcan A. Reversal of late septic shock with supraphysiologic doses of hydrocortisone. Crit Care Med 1998; 26 (04) 645-650
35 López A, Lorente JA, Steingrub J. et al. Multiple-center, randomized, placebo-controlled, double-blind study of the nitric oxide synthase inhibitor 546C88: effect on survival in patients with septic shock. Crit Care Med 2004; 32 (01) 21-30
36 Peake SL, Moran JL, Leppard PI. N-acetyl-L-cysteine depresses cardiac performance in patients with septic shock. Crit Care Med 1996; 24 (08) 1302-1310
37 Rivers E, Nguyen B, Havstad S. et al; Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345 (19) 1368-1377
38 Tuchschmidt J, Fried J, Astiz M, Rackow E. Elevation of cardiac output and oxygen delivery improves outcome in septic shock. Chest 1992; 102 (01) 216-220
39 Groover MP. Fundamentals of Modern Manufacturing: Materials, Processes, and Systems. 5th ed. Hoboken, NJ: John Wiley & Sons, Inc.; 2013
40 Holden RJ, Karsh BT. The technology acceptance model: its past and its future in health care. J Biomed Inform 2010; 43 (01) 159-172
41 Juma C. Innovation and Its Enemies: Why People Resist New Technologies. 1st ed. ed. New York, NY: Oxford University Press; 2016
42 Brogi E, Cyr S, Kazan R, Giunta F, Hemmerling TM. Clinical performance and safety of closed-loop systems: a systematic review and meta-analysis of randomized controlled trials. Anesth Analg 2017; 124 (02) 446-455
43 Battelino T, Omladič JS, Phillip M. Closed loop insulin delivery in diabetes. Best Pract Res Clin Endocrinol Metab 2015; 29 (03) 315-325
44 Elleri D, Maltoni G, Allen JM. et al. Safety of closed-loop therapy during reduction or omission of meal boluses in adolescents with type 1 diabetes: a randomized clinical trial. Diabetes Obes Metab 2014; 16 (11) 1174-1178
45 Hoskins SL, Elgjo GI, Lu J. et al. Closed-loop resuscitation of burn shock. J Burn Care Res 2006; 27 (03) 377-385
46 Salinas J, Drew G, Gallagher J. et al. Closed-loop and decision-assist resuscitation of burn patients. J Trauma 2008; 64 (04) S321-S332
47 Chaisson NF, Kirschner RA, Deyo DJ, Lopez JA, Prough DS, Kramer GC. Near-infrared spectroscopy-guided closed-loop resuscitation of hemorrhage. J Trauma 2003; 54 (05) S183-S192
48 Marques NR, Ford BJ, Khan MN. et al. Automated closed-loop resuscitation of multiple hemorrhages: a comparison between fuzzy logic and decision table controllers in a sheep model. Disaster Mil Med 2017; 3: 1
49 Joosten A, Jame V, Alexander B. et al. Feasibility of fully automated hypnosis, analgesia, and fluid management using 2 independent closed-loop systems during major vascular surgery: a pilot study. Anesth Analg 2019; 128 (06) e88-e92
50 Rinehart J, Lilot M, Lee C. et al. Closed-loop assisted versus manual goal-directed fluid therapy during high-risk abdominal surgery: a case-control study with propensity matching. Crit Care 2015; 19: 94
51 Uemura K, Kawada T, Zheng C, Sugimachi M. Less invasive and inotrope-reduction approach to automated closed-loop control of hemodynamics in decompensated heart failure. IEEE Trans Biomed Eng 2016; 63 (08) 1699-1708
52 Pearse RM, Harrison DA, MacDonald N. et al; OPTIMISE Study Group. Effect of a perioperative, cardiac output-guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: a randomized clinical trial and systematic review. JAMA 2014; 311 (21) 2181-2190
53 Joosten A, Delaporte A, Ickx B. et al. Crystalloid versus colloid for intraoperative goal-directed fluid therapy using a closed-loop system: a randomized, double-blinded, controlled trial in major abdominal surgery. Anesthesiology 2018; 128 (01) 55-66
54 Joosten A, Delaporte A, Mortier J. et al. Long-term impact of crystalloid versus colloid solutions on renal function and disability-free survival after major abdominal surgery. Anesthesiology 2019; 130 (02) 227-236
55 Hammond JJ, Kirkendall WM, Calfee RV. Hypertensive crisis managed by computer controlled infusion of sodium nitroprusside: a model for the closed loop administration of short acting vasoactive agents. Comput Biomed Res 1979; 12 (02) 97-108
56 Bednarski P, Siclari F, Voigt A, Demertzis S, Lau G. Use of a computerized closed-loop sodium nitroprusside titration system for antihypertensive treatment after open heart surgery. Crit Care Med 1990; 18 (10) 1061-1065
57 Murchie CJ, Kenny GN. Comparison among manual, computer-assisted, and closed-loop control of blood pressure after cardiac surgery. J Cardiothorac Anesth 1989; 3 (01) 16-19
58 Rosenfeldt FL, Chang V, Grigg M. et al. A closed loop microprocessor controller for treatment of hypertension after cardiac surgery. Anaesth Intensive Care 1986; 14 (02) 158-162
59 Reid JA, Kenny GN. Evaluation of closed-loop control of arterial pressure after cardiopulmonary bypass. Br J Anaesth 1987; 59 (02) 247-255
60 Martin JF. Closed-loop control of arterial pressure during cardiac surgery. J Clin Monit 1992; 8 (03) 252-255
61 Mackenzie AF, Colvin JR, Kenny GN, Bisset WI. Closed loop control of arterial hypertension following intracranial surgery using sodium nitroprusside. A comparison of intra-operative halothane or isoflurane. Anaesthesia 1993; 48 (03) 202-204
62 McKinley S, Cade JF, Siganporia R, Evans OM, Mason DG, Packer JS. Clinical evaluation of closed-loop control of blood pressure in seriously ill patients. Crit Care Med 1991; 19 (02) 166-170
63 Merouani M, Guignard B, Vincent F. et al. Norepinephrine weaning in septic shock patients by closed loop control based on fuzzy logic. Crit Care 2008; 12 (06) R155
64 Ngan Kee WD, Tam YH, Khaw KS, Ng FF, Critchley LA, Karmakar MK. Closed-loop feedback computer-controlled infusion of phenylephrine for maintaining blood pressure during spinal anaesthesia for caesarean section: a preliminary descriptive study. Anaesthesia 2007; 62 (12) 1251-1256
65 Ngan Kee WD, Tam YH, Khaw KS, Ng FF, Lee SWY. Closed-loop feedback computer-controlled phenylephrine for maintenance of blood pressure during spinal anesthesia for cesarean delivery: a randomized trial comparing automated boluses versus infusion. Anesth Analg 2017; 125 (01) 117-123
66 Ngan Kee WD, Khaw KS, Tam YH, Ng FF, Lee SW. Performance of a closed-loop feedback computer-controlled infusion system for maintaining blood pressure during spinal anaesthesia for caesarean section: a randomized controlled comparison of norepinephrine versus phenylephrine. J Clin Monit Comput 2017; 31 (03) 617-623
67 Rinehart J, Joosten A, Ma M, Calderon MD, Cannesson M. Closed-loop vasopressor control: in-silico study of robustness against pharmacodynamic variability. J Clin Monit Comput 2019; 33 (05) 795-802
68 Joosten A, Delaporte A, Alexander B. et al. Automated titration of vasopressor infusion using a closed-loop controller: in vivo feasibility study using a swine model. Anesthesiology 2019; 130 (03) 394-403
69 Joosten A, Alexander B, Duranteau J. et al. Feasibility of closed-loop titration of norepinephrine infusion in patients undergoing moderate- and high-risk surgery. Br J Anaesth 2019; 123 (04) 430-438
70 Joosten A, Rinehart J. Part of the steamroller and not part of the road: better blood pressure management through automation. Anesth Analg 2017; 125 (01) 20-22
71 Michard F, Liu N, Kurz A. The future of intraoperative blood pressure management. J Clin Monit Comput 2018; 32 (01) 1-4
72 Loeb RG, Cannesson M. Closed-loop anesthesia: ready for prime time?. Anesth Analg 2017; 124 (02) 381-382
73 Pauldine R, Beck G, Salinas J, Kaczka DW. Closed-loop strategies for patient care systems. J Trauma 2008; 64 (04) S289-S294
74 Adams BD, Carr B, Raez A, Hunter CJ. Cardiopulmonary resuscitation in the combat hospital and forward operating base: use of automated external defibrillators. Mil Med 2009; 174 (06) 584-587
75 Terry P, Rushton CH. Allocation of scarce resources: ethical challenges, clinical realities. Am J Crit Care 1996; 5 (05) 326-330
76 Rinehart J, Liu N, Alexander B, Cannesson M. Review article: closed-loop systems in anesthesia: is there a potential for closed-loop fluid management and hemodynamic optimization?. Anesth Analg 2012; 114 (01) 130-143
77 Newswire P. From the battlefield to the medical field: lockheed martin adapts missile defense analytics for early sepsis detection. 2014 ; Accessed Feb 12, 2020 at: https://news.lockheedmartin.com/2014-02-24-From-The-Battlefield-To-The-Medical-Field-Lockheed-Martin-Adapts-Missile-Defense-Analytics-For-Early-Sepsis-Detection
78 Hravnak M, Devita MA, Clontz A, Edwards L, Valenta C, Pinsky MR. Cardiorespiratory instability before and after implementing an integrated monitoring system. Crit Care Med 2011; 39 (01) 65-72
79 Manberg PJ, Vozella CM, Kelley SD. Regulatory challenges facing closed-loop anesthetic drug infusion devices. Clin Pharmacol Ther 2008; 84 (01) 166-169
80 Guillame-Bert M, Dubrawski A, Wang D, Hravnak M, Clermont G, Pinsky MR. Learning temporal rules to forecast instability in continuously monitored patients. J Am Med Inform Assoc 2017; 24 (01) 47-53
81 Hravnak M, Chen L, Bose E. et al. Artifact patterns in continuous noninvasive monitoring of patients. Intensive Care Med 2013; 39 (Suppl. 02) S405
82 Pinsky MR. Complexity modeling: identify instability early. Crit Care Med 2010; 38 (10) S649-S655
83 Pinsky MR, Dubrawski A. Gleaning knowledge from data in the intensive care unit. Am J Respir Crit Care Med 2014; 190 (06) 606-610
84 Hatib F, Jian Z, Buddi S. et al. Machine-learning algorithm to predict hypotension based on high-fidelity arterial pressure waveform analysis. Anesthesiology 2018; 129 (04) 663-674
85 Ranucci M, Barile L, Ambrogi F, Pistuddi V. Surgical, clinical outcome research g. Discrimination and calibration properties of the hypotension probability indicator during cardiac and vascular surgery. Minerva Anestesiol 2018;
86 Davies SJ, Vistisen ST, Jian Z, Hatib F, Scheeren TWL. Ability of an arterial waveform analysis-derived hypotension prediction index to predict future hypotensive events in surgical patients. Anesth Analg 2020; 130 (02) 352-359
87 Schneck E, Schulte D, Habig L. et al. Hypotension Prediction Index based protocolized haemodynamic management reduces the incidence and duration of intraoperative hypotension in primary total hip arthroplasty: a single centre feasibility randomised blinded prospective interventional trial. J Clin Monit Comput 2019;
88 Wijnberge M, Geerts BF, Hol L. et al. Effect of a machine learning-derived early warning system for intraoperative hypotension vs standard care on depth and duration of intraoperative hypotension during elective noncardiac surgery: the HYPE randomized clinical trial. JAMA 2020; 323 (11) 1052-1060
89 Kong E, Nicolaou N, Vizcaychipi MP. Hemodynamic stability of closed-loop anesthesia systems: a systematic review. Minerva Anestesiol 2020; 86 (01) 76-87
90 West N, van Heusden K, Görges M. et al. Design and evaluation of a closed-loop anesthesia system with robust control and safety system. Anesth Analg 2018; 127 (04) 883-894
91 LE Guen M, Liu N, Chazot T, Fischler M. ; M LEG. Closed-loop anesthesia. Minerva Anestesiol 2016; 82 (05) 573-581
92 Joosten A, Huynh T, Suehiro K, Canales C, Cannesson M, Rinehart J. Goal-Directed fluid therapy with closed-loop assistance during moderate risk surgery using noninvasive cardiac output monitoring: a pilot study. Br J Anaesth 2015; 114 (06) 886-892
93 Liu N, Le Guen M, Benabbes-Lambert F. et al. Feasibility of closed-loop titration of propofol and remifentanil guided by the spectral M-Entropy monitor. Anesthesiology 2012; 116 (02) 286-295
94 Luginbühl M, Bieniok C, Leibundgut D, Wymann R, Gentilini A, Schnider TW. Closed-loop control of mean arterial blood pressure during surgery with alfentanil: clinical evaluation of a novel model-based predictive controller. Anesthesiology 2006; 105 (03) 462-470
95 Libert N, Chenegros G, Harrois A. et al. Performance of closed-loop resuscitation of haemorrhagic shock with fluid alone or in combination with norepinephrine: an experimental study. Ann Intensive Care 2018; 8 (01) 89
96 Joosten A, Rinehart J, Bardaji A. et al. Anesthetic management using multiple closed-loop systems and delayed neurocognitive recovery: a randomized controlled trial. Anesthesiology 2020; 132 (02) 253-266
97 Joosten A, Delaporte A, Cannesson M. et al. Fully automated anesthesia and fluid management using multiple physiologic closed-loop systems in a patient undergoing high-risk surgery. A A Case Rep 2016; 7 (12) 260-265
98 Charlson ME, MacKenzie CR, Gold JP, Ales KL, Topkins M, Shires GT. Preoperative characteristics predicting intraoperative hypotension and hypertension among hypertensives and diabetics undergoing noncardiac surgery. Ann Surg 1990; 212 (01) 66-81
99 Reich DL, Wood Jr RK, Emre S. et al. Association of intraoperative hypotension and pulmonary hypertension with adverse outcomes after orthotopic liver transplantation. J Cardiothorac Vasc Anesth 2003; 17 (06) 699-702
100 Kheterpal S, O'Reilly M, Englesbe MJ. et al. Preoperative and intraoperative predictors of cardiac adverse events after general, vascular, and urological surgery. Anesthesiology 2009; 110 (01) 58-66
101 De Maria Jr S, Nürnberg J, Lin HM. et al. Association of intraoperative blood pressure instability with adverse outcomes after liver transplantation. Minerva Anestesiol 2013; 79 (06) 604-616
102 Mascha EJ, Yang D, Weiss S, Sessler DI. Intraoperative Mean Arterial Pressure Variability and 30-day Mortality in Patients Having Noncardiac Surgery. Anesthesiology 2015; 123 (01) 79-91
103 White SM, Moppett IK, Griffiths R. et al. Secondary analysis of outcomes after 11,085 hip fracture operations from the prospective UK Anaesthesia Sprint Audit of Practice (ASAP-2). Anaesthesia 2016; 71 (05) 506-514
104 Hallqvist L, Granath F, Huldt E, Bell M. Intraoperative hypotension is associated with acute kidney injury in noncardiac surgery: An observational study. Eur J Anaesthesiol 2018; 35 (04) 273-279
105 Mizota T, Hamada M, Matsukawa S, Seo H, Tanaka T, Segawa H. Relationship between intraoperative hypotension and acute kidney injury after living donor liver transplantation: a retrospective analysis. J Cardiothorac Vasc Anesth 2017; 31 (02) 582-589
106 Wesselink EM, Kappen TH, Torn HM, Slooter AJC, van Klei WA. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth 2018; 121 (04) 706-721
107 Abbott TEF, Pearse RM, Archbold RA. et al. A prospective international multicentre cohort study of intraoperative heart rate and systolic blood pressure and myocardial injury after noncardiac surgery: results of the VISION study. Anesth Analg 2018; 126 (06) 1936-1945
108 Sun LY, Chung AM, Farkouh ME. et al. Defining an intraoperative hypotension threshold in association with stroke in cardiac surgery. Anesthesiology 2018; 129 (03) 440-447
109 Tang Y, Zhu C, Liu J. et al. Association of intraoperative hypotension with acute kidney injury after noncardiac surgery in patients younger than 60 years old. Kidney Blood Press Res 2019; 44 (02) 211-221
110 Marques NR, Whitehead WE, Kallu UR. et al. Physician-directed versus computerized closed-loop control of blood pressure using phenylephrine in a swine model. Anesth Analg 2017; 125 (01) 110-116
111 Sng BL, Tan HS, Sia AT. Closed-loop double-vasopressor automated system vs manual bolus vasopressor to treat hypotension during spinal anaesthesia for caesarean section: a randomised controlled trial. Anaesthesia 2014; 69 (01) 37-45
112 Sia AT, Tan HS, Sng BL. Closed-loop double-vasopressor automated system to treat hypotension during spinal anaesthesia for caesarean section: a preliminary study. Anaesthesia 2012; 67 (12) 1348-1355