Hemodynamic management is a vital part of the perioperative phase. It can also be a challenge: hemodynamic instability is a constant danger during anesthesia and surgery. Fluctuations in blood pressure may presents themselves as decreases in systolic and mean arterial blood pressure. These hypotensive episodes might be missed by discontinuous upper arm cuff readings.,
Why it is so important to detect blood pressure fluctuations immediately?
MAP<65 mmHg (low perfusion pressure) may lead to tissue hypoxia
During phases of hypotension, the brain, the heart, the kidneys and other vital organs can be deprived of blood flow resulting in tissue hypoperfusion and hypoxia. Acute kidney injury and myocardial injury can be caused by even short periods of hypotension and are leading causes of 30-day postoperative mortality. ,
**Nicklas J, Beckmann D, Killat J et al. Continuous noninvasive arterial blood pressure monitoring using the vascular unloading technology during complex gastrointestinal endoscopy: a prospective observational study. J Clin Monit Comput. 2018;33(1):25-30.
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The individual evaluation of the hemodynamic stability of each and every patient is essential in guiding goal directed therapy. This includes not only the monitoring of blood pressure and the mean arterial pressure (MAP), but also other determinants of the cardiac output like afterload, preload and contractility of the heart.
Facts and figures on intraoperative hypotension
Hypotensive phases during anesthesia and surgery are quite common. Several studies found relationships between low mean arterial pressure (MAP) and an increased risk for postoperative complications.
Learn more about complication rates, treatment options and financial prospects. Our interactive study summary offers facts and figures at a glance.
1. Vafi Salmasi, Kamal Maheshwari, Dongsheng Yang, Edward J. Mascha, Asha Singh, Daniel I. Sessler, Andrea Kurz; 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(1):47-65. doi:
2. Jilles B. Bijker, Suzanne Persoon, Linda M. Peelen, Karel G. M. Moons, Cor J. Kalkman, L. Jaap Kappelle, Wilton A. van Klei; Intraoperative Hypotension and Perioperative Ischemic Stroke after General Surgery: A Nested Case-control Study. Anesthesiology 2012;116(3):658-664. doi: