Use of Hypotension Prediction Index to Reduce Intraoperative Hypotension in Major Thoracic Surgery

Use of Hypotension Prediction Index to Reduce Intraoperative Hypotension in Major Thoracic Surgery

Intraoperative hypotension is linked to increased incidence of perioperative adverse events such as myocardial and cerebrovascular infarction and acute kidney injury. Hypotension prediction index (HPI) is a novel machine learning guided algorithm which can predict hypotensive events using high fidelity analysis of pulse-wave contour. Goal of this trial is to determine whether use of HPI can reduce the number and duration of hypotensive events in patients undergoing major thoracic procedures.

Inclusion Criteria:

• patients over 18 years of age
• patients scheduled for elective major thoracic procedure (lung resection, pleurectomy or resection of the esophagus)
• planned thoracotomy and intraoperative period of one lung ventilation
• planned postoperative admission to the ICU

Exclusion criteria:

• persistent atrial fibrillation
• structural heart defects (shunting or moderate to severe valvular anomalies)
• preoperative serum hemoglobin levels < 120 g/L
• severe heart failure classified as New York Heart Association (NYHA) grade IV