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The incidence of intraoperative hypotension was 91%. The increasing incidence of intraoperative hypotension would increase the risk of postoperative complications, such as postoperative arrythmia, stroke or acute kidney injury. Major gastrointestinal surgery is a major surgery. Older patients usually have many comorbidity, such as hypertension or cardiovascular disease. Prevention intraoperative hypotension is an important issue. Hypotension prediction index (HPI) could give the clinician pre-alarm of hypotension (mean arterial pressure (MAP)<65mmHg). In this study, we aimed to investigate whether HPI could prevent the intraoperative hypotension happened in patients receive elective major gastrointestinal surgery with older than 65 years old.
Background: the incidence of intraoperative hypotension was 91%. The increasing incidence of intraoperative hypotension would increase the risk of postoperative complications, such as postoperative arrythmia, stroke or acute kidney injury. Major gastrointestinal surgery is a major surgery. Older patients usually have many comorbidity, such as hypertension or cardiovascular disease. Prevention intraoperative hypotension is an important issue. Hypotension prediction index (HPI) could give the clinician pre-alarm of hypotension (mean arterial pressure (MAP)<65mmHg).
Objectives: to investigate whether HPI could prevent the intraoperative hypotension happened.
Patients and methods: The patients receive elective major gastrointestinal surgery with older than 65 years old. These patients have divided into two groups, including with/without HPI guided. The intraoperative hypotension incidence has been measured.
Expected result: The HPI would significantly decrease the intraoperative hypotension incidence.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| hypotension prediction index guided | Experimental | Patients receiving hypotension prediction index guided. In this group, they will be alerted when the index exceeded 85 (range 0 to 100) indicating the later occurrence of MAP< 65mmHg for at least minutes and a treatment protocol based on advanced hemodynamic parameters recommended vasopressor or inotrope, fluid administration, or observation. |
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| without hypotesion prediction index guided | Sham Comparator | Patients will receive usual care during the operation without hypotension prediction index alerted. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| hypotension prediction index guided | Device | patients receiving hypotension prediction index monitoring and let the anesthesiologist' alerted the coming intraoperatiobe hypotension |
| Measure | Description | Time Frame |
|---|---|---|
| Time-weighted average mean arterial pressure less than 65 mmHg | A higher data of time-weighted average mean arterial pressure less than 65 mmHg indicates severe and longer intraoperative hypotension | preoperative and postoperative 30 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chih-Jun Lai, MD | National Taiwan University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chih-Jun Lai | Taipei | Zhongzheng | 100225 | Taiwan |
ethical issue: patients' privacy
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The patients receive elective major gastrointestinal surgery with older than 65 years old. These patients have divided into two groups, including with/without HPI guided. The intraoperative hypotension incidence has been measured.
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patients and care providers did not know the whether the hypotension prediction index use during the operation.
| without hypotesion prediction index guided | Other | patients receiving usual care without hypotension prediction index monitoring but with usual arterial line care |
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